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General NPI Number Information
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NPI Number | 1255699013
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Entity Type | Organization
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Legal Business Name | POWER COUNSELING AND TREATMENT SERVICES, LLC
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Dates
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Enumeration Date | 04/30/2012
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Last Update Date | 05/08/2024
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Provider Practice Location Address
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Address Line | 1071 E LANDIS AVE STE 3
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City | VINELAND
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State | NJ
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Zip | 08360-4060
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Country | US
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Telephone | 202-813-0454
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Fax | 202-813-0454
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Provider Business Mailing Address
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Address Line | 6828 WALKWAY CT STE B
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City | BRYANS ROAD
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State | MD
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Zip | 20616-6106
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Country | US
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Telephone | 202-813-0454
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Fax | 202-813-0454
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Authorized Official
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Title or Position | DIRECTOR
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Name | MR. AZUBIKE INNOCENT ALICHE
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Credential | LCSW
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Telephone | 202-813-0454
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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