| Christus Institute For Family Life, Llc | |
|
101 Mountain Ct Ste 101b Hackettstown NJ 07840-2300 | |
| (908) 455-1117 | |
| Not Available |
| Full Name | Christus Institute For Family Life, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 101 Mountain Ct Ste 101b, Hackettstown, New Jersey |
| Authorized Official Name and Position | Laurene Lynn Clossey (MANAGING DIRECTOR) |
| Authorized Official Contact | 9084551117 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Christus Institute For Family Life, Llc Po Box 7118 Hackettstown NJ 07840-7118 Ph: (908) 455-1117 | Christus Institute For Family Life, Llc 101 Mountain Ct Ste 101b Hackettstown NJ 07840-2300 Ph: (908) 455-1117 |
| NPI Number | 1720306111 |
|---|---|
| Provider Enumeration Date | 05/10/2010 |
| Last Update Date | 04/22/2021 |
| Certification Date | 04/22/2021 |
| Medicare PECOS PAC ID | 1153446208 |
|---|---|
| Medicare Enrollment ID | O20100914000382 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720306111 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 44SC05363900 (New Jersey) | Primary |
| Provider Name | Laurene L Clossey |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1215254925 PECOS PAC ID: 7911022066 Enrollment ID: I20100914000612 |
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