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General NPI Number Information
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NPI Number | 1093018343
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Entity Type | Organization
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Legal Business Name | PINNACLE TREATMENT CENTERS NJ-V
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Dates
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Enumeration Date | 12/08/2010
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Last Update Date | 12/08/2010
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Provider Practice Location Address
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Address Line | 206 BERGEN AVE
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City | KEARNY
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State | NJ
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Zip | 07032-3384
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Country | US
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Telephone | 201-991-0035
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Fax | 201-991-2066
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Provider Business Mailing Address
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Address Line | 25 E FRONT ST
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City | KEYPORT
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State | NJ
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Zip | 07735-1562
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Country | US
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Telephone | 732-264-3824
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Fax | 732-264-6497
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Authorized Official
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Title or Position | AVP/CONTROLLER
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Name | MR. SCOTT COHEN
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Credential |
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Telephone | 732-264-3824
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number |
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License Number State | NJ
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