| Boys & Girls Club Of Newark Wellness Center | |
|
1 Avon Ave Newark NJ 07108-2801 | |
| (973) 242-1200 | |
| Not Available |
| Full Name | Boys & Girls Club Of Newark Wellness Center |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 1 Avon Ave, Newark, New Jersey |
| Authorized Official Name and Position | Gardan Speights (DIRECTOR OF COMMUNITY WELLNESS) |
| Authorized Official Contact | 6462365695 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Boys & Girls Club Of Newark Wellness Center 1 Avon Ave Newark NJ 07108-2801 Ph: (973) 242-1200 | Boys & Girls Club Of Newark Wellness Center 1 Avon Ave Newark NJ 07108-2801 Ph: (973) 242-1200 |
| NPI Number | 1164006797 |
|---|---|
| Provider Enumeration Date | 05/10/2021 |
| Last Update Date | 12/13/2021 |
| Certification Date | 12/13/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164006797 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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