| Kwenyan Professional Health Services, Llc | |
|
60 Evergreen Pl Suite 500 East Orange NJ 07018-2106 | |
| (973) 672-6900 | |
| (866) 376-8262 |
| Full Name | Kwenyan Professional Health Services, Llc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 60 Evergreen Pl, East Orange, New Jersey |
| Authorized Official Name and Position | Daniel Cassell (EXECUTIVE DIRECTOR/PRESIDENT) |
| Authorized Official Contact | 9736726900 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kwenyan Professional Health Services, Llc 60 Evergreen Pl Suite 500 East Orange NJ 07018-2106 Ph: (973) 672-6900 | Kwenyan Professional Health Services, Llc 60 Evergreen Pl Suite 500 East Orange NJ 07018-2106 Ph: (973) 672-6900 |
| NPI Number | 1629221239 |
|---|---|
| Provider Enumeration Date | 10/28/2008 |
| Last Update Date | 06/02/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629221239 | NPI | - | NPPES |
| 0175366 | Medicaid | NJ |
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