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General NPI Number Information
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NPI Number | 1346468824
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Entity Type | Organization
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Legal Business Name | CUMBERLAND COUNTY ALCOHOL AND DRUG ABUSE SERVICES
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Dates
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Enumeration Date | 04/23/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 72 N PEARL ST
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City | BRIDGETON
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State | NJ
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Zip | 08302-1943
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Country | US
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Telephone | 856-451-3727
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Fax | 856-455-9706
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Provider Business Mailing Address
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Address Line | 72 NORTH PEARL STREET
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City | BRIDGETON
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State | NJ
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Zip | 08302
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Country | US
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Telephone | 856-451-3727
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Fax | 856-455-9706
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MRS. JUANITA NAZARIO
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Credential | MHS, MSC, LCADC
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Telephone | 856-451-3727
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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 | 23030
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License Number State | NJ
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