| Holistic Bonfire Llc | |
|
258 Newark St Suite 205 Hoboken NJ 07030-3419 | |
| (908) 376-9036 | |
| Not Available |
| Full Name | Holistic Bonfire Llc |
|---|---|
| Speciality | Counselor |
| Location | 258 Newark St, Hoboken, New Jersey |
| Authorized Official Name and Position | Suruchi Saini (PRINCIPAL) |
| Authorized Official Contact | 9083769036 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Holistic Bonfire Llc 571 Buckingham Dr Piscataway NJ 08854-6259 Ph: () - | Holistic Bonfire Llc 258 Newark St Suite 205 Hoboken NJ 07030-3419 Ph: (908) 376-9036 |
| NPI Number | 1962940270 |
|---|---|
| Provider Enumeration Date | 02/07/2017 |
| Last Update Date | 01/15/2024 |
| Certification Date | 01/15/2024 |
| Medicare PECOS PAC ID | 1759725054 |
|---|---|
| Medicare Enrollment ID | O20240214002984 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962940270 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | 37PC00425500 (New Jersey) | Primary |
| Provider Name | Suruchi Saini |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1578714085 PECOS PAC ID: 4486098787 Enrollment ID: I20240214003071 |
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