| James Park Healthcare Inc | |
|
5 Stuyvesant Ave Newark NJ 07106-1711 | |
| (973) 399-3336 | |
| Not Available |
| Full Name | James Park Healthcare Inc |
|---|---|
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 5 Stuyvesant Ave, Newark, New Jersey |
| Authorized Official Name and Position | Michelle Reese Covington (OWNER) |
| Authorized Official Contact | 9733993336 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| James Park Healthcare Inc Po Box 692 Roselle NJ 07203-0692 Ph: (973) 399-3336 | James Park Healthcare Inc 5 Stuyvesant Ave Newark NJ 07106-1711 Ph: (973) 399-3336 |
| NPI Number | 1174629810 |
|---|---|
| Provider Enumeration Date | 09/16/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174629810 | NPI | - | NPPES |
| 0021717 | Medicaid | NJ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | MA038265 (New Jersey) | Primary |
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