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General NPI Number Information
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NPI Number | 1023259348
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Entity Type | Organization
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Legal Business Name | NORTH HUDSON COMMUNITY ACTION CORP. HEALTH CENTER
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Dates
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Enumeration Date | 03/17/2009
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Last Update Date | 03/17/2009
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Provider Practice Location Address
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Address Line | 5301 BROAWAY
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City | WEST NEW YORK
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State | NJ
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Zip | 07093
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Country | US
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Telephone | 201-866-9320
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Fax | 201-330-3825
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Provider Business Mailing Address
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Address Line | 5301 BROADWAY 2ND FLOOR
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City | WEST NEW YORK
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State | NJ
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Zip | 07093-2622
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Country | US
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Telephone | 201-866-9320
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Fax | 201-330-3825
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Authorized Official
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Title or Position | SUBSTANCE ABUSE COUNSELOR
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Name | MR. ROBERTO NEGRON
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Credential | LCADC
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Telephone | 201-866-9320
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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 | 37LC00064700
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License Number State | NJ
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