NPI | 1851444376 |
---|---|
Doing Business As | DBA: HEALTHY CONNECTIONS, DBA:5TH STREET MEDICAL CLINIC |
Entity Type | Organization |
Authorized Contact | DENISE WINANT Credentialing Supervisor 732-570-0268 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM2800X Clinic/Center, Methadone Clinic |
Additional Taxonomies | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: CA 39-12) |
Enumeration Date | 2007-01-19 |
Last Update Date | 2024-02-16 |