| Theracouch | |
|
1892 Manor Dr Union NJ 07083-4512 | |
| (973) 671-5511 | |
| Not Available |
| Full Name | Theracouch |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 1892 Manor Dr, Union, New Jersey |
| Authorized Official Name and Position | Isheaba Ellis (OWNER) |
| Authorized Official Contact | 9736715511 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Theracouch 1892 Manor Dr Apt D Union NJ 07083-4512 Ph: (862) 236-2225 | Theracouch 1892 Manor Dr Union NJ 07083-4512 Ph: (973) 671-5511 |
| NPI Number | 1558972885 |
|---|---|
| Provider Enumeration Date | 08/11/2020 |
| Last Update Date | 08/11/2020 |
| Certification Date | 08/11/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558972885 | NPI | - | NPPES |
| 1548896806 | Other | NJ | MANAGED CARE INSURANCE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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