| Intervention Specialist | |
|
583 Cherry St Elizabeth NJ 07208-1754 | |
| (973) 953-8896 | |
| (973) 953-8896 |
| Full Name | Intervention Specialist |
|---|---|
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 583 Cherry St, Elizabeth, New Jersey |
| Authorized Official Name and Position | Rohan Campbell (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 9082890700 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Intervention Specialist Po Box 6063 West Orange NJ 07052-9063 Ph: (973) 953-8896 | Intervention Specialist 583 Cherry St Elizabeth NJ 07208-1754 Ph: (973) 953-8896 |
| NPI Number | 1043725161 |
|---|---|
| Provider Enumeration Date | 12/12/2017 |
| Last Update Date | 12/12/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043725161 | NPI | - | NPPES |
| 0501433 | Other | NJ | SAI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Primary |
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