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General NPI Number Information
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NPI Number | 1376012310
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Entity Type | Organization
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Legal Business Name | FAMILY SERVICE BUREAU OF NEWARK
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Dates
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Enumeration Date | 11/20/2018
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Last Update Date | 11/20/2018
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Provider Practice Location Address
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Address Line | 274 S ORANGE AVE
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City | NEWARK
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State | NJ
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Zip | 07103-2419
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Country | US
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Telephone | 973-412-2056
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Fax | 973-484-3452
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Provider Business Mailing Address
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Address Line | 274 S ORANGE AVE
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City | NEWARK
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State | NJ
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Zip | 07103-2419
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Country | US
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Telephone | 973-412-2056
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Fax | 973-484-3452
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Authorized Official
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Title or Position | DIRECTOR OF OPERATIONS
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Name | CHISHU CHOU
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Credential | LPC, LCADC
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Telephone | 973-412-2056
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0802X
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Taxonomy Name | Addiction Psychiatry Physician
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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