| Real House Inc | |
|
95 Grove St Montclair NJ 07042-4005 | |
| (973) 746-2400 | |
| Not Available |
| Full Name | Real House Inc |
|---|---|
| Speciality | Clinic/center |
| Location | 95 Grove St, Montclair, New Jersey |
| Authorized Official Name and Position | Diane M Anglin (SENIOR DIRECTOR) |
| Authorized Official Contact | 9737462400 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Real House Inc 95 Grove Street Monclair NJ 07042-4005 Ph: (973) 746-2400 | Real House Inc 95 Grove St Montclair NJ 07042-4005 Ph: (973) 746-2400 |
| NPI Number | 1508069402 |
|---|---|
| Provider Enumeration Date | 06/07/2007 |
| Last Update Date | 08/20/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508069402 | NPI | - | NPPES |
| 0079782 | Medicaid | NJ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 2000081-05 (New Jersey) | Primary |
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