| None | |
|
204 Claremont Ave Montclair NJ 07042-3409 | |
| (973) 746-0800 | |
| (973) 746-2822 |
| Full Name | None |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 204 Claremont Ave, Montclair, New Jersey |
| Authorized Official Name and Position | Sarah B. Wolman (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 9737460800 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| None 204 Claremont Ave Montclair NJ 07042-3409 Ph: (973) 746-0800 | None 204 Claremont Ave Montclair NJ 07042-3409 Ph: (973) 746-0800 |
| NPI Number | 1679703177 |
|---|---|
| Provider Enumeration Date | 07/17/2009 |
| Last Update Date | 07/17/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679703177 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 44SC00358600 (New Jersey) | Primary |
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