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General NPI Number Information
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NPI Number | 1750824579
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Entity Type | Organization
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Legal Business Name | SARA C REEVES
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Dates
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Enumeration Date | 11/28/2016
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Last Update Date | 11/28/2016
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Provider Practice Location Address
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Address Line | 19 RIDGE ST.
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City | ALPINE
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State | NJ
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Zip | 07620
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Country | US
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Telephone | 201-767-7438
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Fax |
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Provider Business Mailing Address
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Address Line | 19 RIDGE STREET
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City | ALPINE
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State | NJ
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Zip | 07620-0913
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Country | US
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Telephone | 201-767-7438
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Fax |
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Authorized Official
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Title or Position | SOCIAL WORKER
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Name | MRS. SARA C REEVES
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Credential | LCSW
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Telephone | 201-767-7438
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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 | 44SC01168900
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License Number State | NJ
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