| Outsiders Youth Association | |
|
100 Dana St Phillipsburg NJ 08865-1937 | |
| (973) 855-1206 | |
| Not Available |
| Full Name | Outsiders Youth Association |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 100 Dana St, Phillipsburg, New Jersey |
| Authorized Official Name and Position | Azanae Diggs-jackson (CEO) |
| Authorized Official Contact | 9738551206 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Outsiders Youth Association 100 Dana St Phillipsburg NJ 08865-1937 Ph: (973) 855-1206 | Outsiders Youth Association 100 Dana St Phillipsburg NJ 08865-1937 Ph: (973) 855-1206 |
| NPI Number | 1346079399 |
|---|---|
| Provider Enumeration Date | 07/29/2024 |
| Last Update Date | 07/29/2024 |
| Certification Date | 07/29/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346079399 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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