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General NPI Number Information
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NPI Number | 1457623225
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Entity Type | Organization
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Legal Business Name | CLIENT ACTION & RESOURCE EMPOWERMENT
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Dates
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Enumeration Date | 02/08/2012
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Last Update Date | 02/08/2012
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Provider Practice Location Address
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Address Line | 555 PREAKNESS AVE
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City | TOTOWA
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State | NJ
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Zip | 07502-1012
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Country | US
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Telephone | 973-341-9869
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Fax | 973-689-7271
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Provider Business Mailing Address
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Address Line | 555 PREAKNESS AVE
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City | TOTOWA
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State | NJ
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Zip | 07502-1012
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Country | US
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Telephone | 973-341-9869
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Fax | 973-689-7271
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Authorized Official
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Title or Position | CEO
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Name | GABRIEL MONTERO
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Credential | MS, LMHC
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Telephone | 973-341-9869
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number | 2000493-11
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 2000493-11
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License Number State | NJ
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