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General NPI Number Information
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NPI Number | 1013427848
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Entity Type | Organization
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Legal Business Name | EILEEN WEBER
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Dates
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Enumeration Date | 10/06/2017
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Last Update Date | 10/16/2017
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Provider Practice Location Address
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Address Line | 75 VETERANS MEMORIAL DR E STE 205
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City | SOMERVILLE
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State | NJ
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Zip | 08876-2949
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Country | US
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Telephone | 908-704-0011
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Fax | 908-704-0711
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Provider Business Mailing Address
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Address Line | 75 VETERANS MEMORIAL DR E STE 205
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City | SOMERVILLE
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State | NJ
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Zip | 08876-2949
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Country | US
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Telephone | 908-704-0011
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Fax | 908-704-0711
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | EILEEN WEBER
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Credential |
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Telephone | 908-704-0011
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 2000133
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License Number State | NJ
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