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General NPI Number Information
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NPI Number | 1720993843
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Entity Type | Organization
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Legal Business Name | CHOSEN GENERATION COMMUNITY CORPORATION
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Dates
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Enumeration Date | 08/14/2026
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Last Update Date | 08/14/2026
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Provider Practice Location Address
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Address Line | 147 MONTGOMERY ST
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City | PATERSON
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State | NJ
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Zip | 07501-1117
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Country | US
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Telephone | 973-782-6726
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Fax | 973-782-6727
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Provider Business Mailing Address
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Address Line | 147 MONTGOMERY ST
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City | PATERSON
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State | NJ
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Zip | 07501-1117
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Country | US
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Telephone | 973-782-6726
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Fax | 973-782-6727
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Authorized Official
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Title or Position | CEO
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Name | DR. WILLIE MOODY
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Credential | PHD
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Telephone | 203-947-7416
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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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