| Act | |
|
60 W Ridgewood Ave 3rd Floor Ridgewood NJ 07450-3197 | |
| (201) 967-1100 | |
| (201) 568-6339 |
| Full Name | Act |
|---|---|
| Speciality | Counselor - Professional |
| Location | 60 W Ridgewood Ave, Ridgewood, New Jersey |
| Authorized Official Name and Position | Steven Khanjian (PRESIDENT) |
| Authorized Official Contact | 2019671100 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Act 60 W Ridgewood Ave 3rd Floor Ridgewood NJ 07450-3197 Ph: (201) 967-1100 | Act 60 W Ridgewood Ave 3rd Floor Ridgewood NJ 07450-3197 Ph: (201) 967-1100 |
| NPI Number | 1477605384 |
|---|---|
| Provider Enumeration Date | 01/18/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477605384 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 37LC00126800 (New Jersey) | Primary |
| 101YP2500X | Counselor - Professional | 37PC00197500 (New Jersey) | Primary |
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