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General NPI Number Information
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NPI Number | 1669619052
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Entity Type | Organization
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Legal Business Name | COVENANT HOUSE NEW JERSEY, INC.
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Dates
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Enumeration Date | 01/07/2009
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Last Update Date | 09/02/2025
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Provider Practice Location Address
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Address Line | 330 WASHINGTON ST
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City | NEWARK
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State | NJ
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Zip | 07102-2630
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Country | US
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Telephone | 973-286-3547
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Fax | 973-286-0190
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Provider Business Mailing Address
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Address Line | 330 WASHINGTON ST
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City | NEWARK
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State | NJ
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Zip | 07102-2630
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Country | US
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Telephone | 973-286-3419
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Fax | 973-286-0190
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Authorized Official
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Title or Position | SENIOR DIRECTOR
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Name | MEGHAN LEIGH
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Credential |
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Telephone | 973-286-3419
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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