| Stanford Angels Llc | |
|
1600 Saint Georges Ave Ste 301 Rahway NJ 07065-2713 | |
| (848) 336-0965 | |
| (908) 248-0804 |
| Full Name | Stanford Angels Llc |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 1600 Saint Georges Ave Ste 301, Rahway, New Jersey |
| Authorized Official Name and Position | Catina Burkett (SOCIAL WORK CLINICAL SUPERVISOR) |
| Authorized Official Contact | 2018142759 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Stanford Angels Llc 1600 Saint Georges Ave Ste 301 Rahway NJ 07065-2713 Ph: (848) 336-0965 | Stanford Angels Llc 1600 Saint Georges Ave Ste 301 Rahway NJ 07065-2713 Ph: (848) 336-0965 |
| NPI Number | 1770330730 |
|---|---|
| Provider Enumeration Date | 05/06/2024 |
| Last Update Date | 08/20/2024 |
| Certification Date | 08/20/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770330730 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Secondary |
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
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