| Clear Lake Addiction And Trauma Center Llc | |
|
504 Regency Pl Lawrenceville NJ 08648-2576 | |
| (609) 498-9003 | |
| Not Available |
| Full Name | Clear Lake Addiction And Trauma Center Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 504 Regency Pl, Lawrenceville, New Jersey |
| Authorized Official Name and Position | Ricardo Alvarez (CEO) |
| Authorized Official Contact | 6094989003 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Clear Lake Addiction And Trauma Center Llc 504 Regency Pl Lawrenceville NJ 08648-2576 Ph: (609) 498-9003 | Clear Lake Addiction And Trauma Center Llc 504 Regency Pl Lawrenceville NJ 08648-2576 Ph: (609) 498-9003 |
| NPI Number | 1295414001 |
|---|---|
| Provider Enumeration Date | 07/18/2023 |
| Last Update Date | 07/18/2023 |
| Certification Date | 07/18/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295414001 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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