| Generationsof Change, Llc | |
|
13 Municipal Plz #2504 Bloomfield NJ 07003-7200 | |
| (973) 223-2172 | |
| (973) 675-2251 |
| Full Name | Generationsof Change, Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 13 Municipal Plz, Bloomfield, New Jersey |
| Authorized Official Name and Position | Richard Greene (OWNER) |
| Authorized Official Contact | 9732232172 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Generationsof Change, Llc 13 Municipal Plz #2504 Bloomfield NJ 07003-7200 Ph: (973) 223-2172 | Generationsof Change, Llc 13 Municipal Plz #2504 Bloomfield NJ 07003-7200 Ph: (973) 223-2172 |
| NPI Number | 1124394531 |
|---|---|
| Provider Enumeration Date | 03/29/2012 |
| Last Update Date | 03/29/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124394531 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 44SC05463500 (New Jersey) | Primary |
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