Healthcare Provider Details

I. General information

NPI: 1548646342
Provider Name (Legal Business Name): ENLIGHTENED SOLUTIONS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/04/2015
Last Update Date: 11/10/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 TILTON RD
EGG HARBOR CITY NJ
08215-5125
US

IV. Provider business mailing address

501 TILTON RD
EGG HARBOR CITY NJ
08215-5125
US

V. Phone/Fax

Practice location:
  • Phone: 609-270-5050
  • Fax:
Mailing address:
  • Phone: 609-823-9300
  • Fax: 609-823-9505

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number StateNJ

VIII. Authorized Official

Name: MRS. JENNIFER HANSEN
Title or Position: OWNER/OPERATOR
Credential:
Phone: 609-270-5050