Parkside Medical Center
LBN: Khaleidoscope Health Care Inc.
Parkside Medical Center is an health care organization with primary practice located at 75 Harrison Avenue , Jersey City NJ 07304-0070. The organization recently has 8 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Clinical, Dental Providers / General Practice, Dietary & Nutritional Service Providers / Nutrition, Education, Dietary & Nutritional Service Providers / Dietitian, Registered, Allopathic & Osteopathic Physicians / Psychiatry, Ambulatory Health Care Facilities / Multi-Specialty, Ambulatory Health Care Facilities / Methadone. Dental Providers / General Practice is the primary health care specialty.
Khaleidoscope Health Care Inc. can be contacted via phone (201) 451-5425, or through Blake, Larry M via phone (201) 451-5425.
Contact Information
Primary practice address
75 Harrison Avenue
Jersey City NJ 07304-0070
Phone: (201) 451-5425
Fax: (201) 451-7499
Website:
Authorized official contact:
Name: Blake, Larry M Licensed Clinical Social Worker (LCSW)
Phone: (201) 451-5425
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 101YA0400X | New Jersey | |
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | New Jersey | |
| Dental Providers / General Practice | 1223G0001X | New Jersey | |
| Dietary & Nutritional Service Providers / Nutrition, Education | 133NN1002X | New Jersey | |
| Dietary & Nutritional Service Providers / Dietitian, Registered | 133V00000X | New Jersey | |
| Allopathic & Osteopathic Physicians / Psychiatry | 2084P0800X | New Jersey | |
| Ambulatory Health Care Facilities / Multi-Specialty | 261QM1300X | New Jersey | |
| Ambulatory Health Care Facilities / Methadone | 261QM2800X | 22613 | New Jersey |
Profile Details
| NPI number | 1336350909 |
|---|---|
| LBN Legal business name | Khaleidoscope Health Care Inc. |
| DBA Doing business as | Parkside Medical Center |
| Authorized official | Blake, Larry M Licensed Clinical Social Worker (LCSW) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | May 25th, 2007 |
| Last updated | Oct 6th, 2023 - about 2 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1336350909 | NPPES |
| New Jersey | MEDICAID | 7734301 | |
| New Jersey | MEDICAID | 6103201 | |
| New Jersey | MEDICAID | 7864108 |
Popular Providers
-
Drs Davis Saltzberg Wenger
142 Palisade Ave , Jersey City NJ 07306 -
Ararat Dental
3171 John F Kennedy Blvd , Jersey City NJ 07306-3522 -
Dr M David Isaak Dental Group
2778 John F Kennedy Blvd , Jersey City NJ 07306-5508 -
L&B Llc
3338 Kennedy Boulevard , Jersey City NJ 07307 -
Om Dental Care Pc
480 Central Avenue , Jersey City NJ 07307 -
Avm Dental Center
282 Grand St , Jersey City NJ 07302-4318 -
Suzana Dental Office
134 Ocean Ave , Jersey City NJ 07305 -
Victoria S. Pedoeem, Dds
3426 Kennedy Blvd. , Jersey City NJ 07307