| Explore Transform Llc | |
|
235 Orchard Pl Ridgewood NJ 07450-4903 | |
| (201) 779-6917 | |
| Not Available |
| Full Name | Explore Transform Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 235 Orchard Pl, Ridgewood, New Jersey |
| Authorized Official Name and Position | Chris Warren-dickins (OWNER) |
| Authorized Official Contact | 2017796917 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Explore Transform Llc 143 E Ridgewood Ave # 1484 Ridgewood NJ 07450-3815 Ph: (201) 779-6917 | Explore Transform Llc 235 Orchard Pl Ridgewood NJ 07450-4903 Ph: (201) 779-6917 |
| NPI Number | 1770202467 |
|---|---|
| Provider Enumeration Date | 08/25/2022 |
| Last Update Date | 08/25/2022 |
| Certification Date | 08/25/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770202467 | NPI | - | NPPES |
| 37PC00618700 | Other | NJ | LICENCE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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