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General NPI Number Information
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NPI Number | 1134489537
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Entity Type | Organization
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Legal Business Name | RESCUE MISSION OF TRENTON
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Dates
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Enumeration Date | 05/21/2012
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Last Update Date | 06/12/2025
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Provider Practice Location Address
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Address Line | 72 EWING ST
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City | TRENTON
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State | NJ
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Zip | 08609-1027
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Country | US
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Telephone | 609-695-1436
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Fax |
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Provider Business Mailing Address
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Address Line | 98 CARROLL ST PO BOX 790
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City | TRENTON
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State | NJ
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Zip | 08609-1008
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Country | US
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Telephone | 609-815-3985
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Fax |
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | BARRETT YOUNG
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Credential |
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Telephone | 609-396-2183
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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 | 2000107
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License Number State | NJ
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