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1200 Clinton Ave Ste 100c1 Irvington NJ 07111-2070 | |
| (862) 576-3281 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1200 Clinton Ave Ste 100c1, Irvington, New Jersey |
| Authorized Official Name and Position | Folashade E Adebiyi (DIRECTOR) |
| Authorized Official Contact | 9086564387 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
33 Rich St Irvington NJ 07111-2020 Ph: (908) 656-4387 | 1200 Clinton Ave Ste 100c1 Irvington NJ 07111-2070 Ph: (862) 576-3281 |
| NPI Number | 1346864212 |
|---|---|
| Provider Enumeration Date | 06/05/2020 |
| Last Update Date | 01/12/2025 |
| Certification Date | 01/12/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346864212 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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