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General NPI Number Information
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NPI Number | 1578927802
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Entity Type | Organization
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Legal Business Name | MCCLENDON RECOVERY INITIATIVES INC.
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Dates
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Enumeration Date | 04/13/2016
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Last Update Date | 09/28/2023
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Provider Practice Location Address
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Address Line | 371 HOES LN STE 200
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City | PISCATAWAY
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State | NJ
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Zip | 08854-4143
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Country | US
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Telephone | 732-903-2175
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 543
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City | PISCATAWAY
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State | NJ
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Zip | 08855-0543
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Country | US
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Telephone | 732-903-2175
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. JENNIFER MCCLENDON
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Credential | LPC, LCADC
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Telephone | 732-903-2175
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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Taxonomy #2
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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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 |
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License Number State |
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