| Theracare Of New Jersey Llc | |
|
67 Walnut Ave Suite 306 Clark NJ 07066-1640 | |
| (888) 311-2611 | |
| Not Available |
| Full Name | Theracare Of New Jersey Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 67 Walnut Ave, Clark, New Jersey |
| Authorized Official Name and Position | John Calderon (PRESIDENT) |
| Authorized Official Contact | 2125642350 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Theracare Of New Jersey Llc 67 Walnut Ave Suite 306 Clark NJ 07066-1640 Ph: (888) 311-2611 | Theracare Of New Jersey Llc 67 Walnut Ave Suite 306 Clark NJ 07066-1640 Ph: (888) 311-2611 |
| NPI Number | 1174669626 |
|---|---|
| Provider Enumeration Date | 01/30/2007 |
| Last Update Date | 12/11/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174669626 | NPI | - | NPPES |
| 0038679 | Medicaid | NJ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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