| 4bienestar Llc | |
|
305 Park Ave # 2 Rutherford NJ 07070-2748 | |
| (201) 207-9243 | |
| (888) 627-5578 |
| Full Name | 4bienestar Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 305 Park Ave # 2, Rutherford, New Jersey |
| Authorized Official Name and Position | Derrick Alloway (CEO) |
| Authorized Official Contact | 8624143186 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| 4bienestar Llc 305 Park Ave # 2 Rutherford NJ 07070-2748 Ph: (201) 207-9243 | 4bienestar Llc 305 Park Ave # 2 Rutherford NJ 07070-2748 Ph: (201) 207-9243 |
| NPI Number | 1134735640 |
|---|---|
| Provider Enumeration Date | 09/20/2020 |
| Last Update Date | 09/20/2020 |
| Certification Date | 09/20/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134735640 | NPI | - | NPPES |
| 0161772 | Medicaid | NJ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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