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General NPI Number Information
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NPI Number | 1346600665
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Entity Type | Organization
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Legal Business Name | PRINCETON AFTERCARE, INC.
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Dates
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Enumeration Date | 02/29/2016
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Last Update Date | 02/29/2016
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Provider Practice Location Address
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Address Line | 4451 ROUTE 27
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City | PRINCETON
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State | NJ
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Zip | 08540-8708
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Country | US
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Telephone | 609-955-6111
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Fax |
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Provider Business Mailing Address
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Address Line | 4451 ROUTE 27
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City | PRINCETON
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State | NJ
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Zip | 08540-8708
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Country | US
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Telephone | 609-955-6111
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Fax |
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Authorized Official
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Title or Position | CLINICAL DIRECTOR / ADMINISTRATOR
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Name | MR. DAVID ARTHUR ERRICKSON
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Credential | LCSW, LCADC
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Telephone | 609-955-6111
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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 | 2000624
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License Number State | NJ
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