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General NPI Number Information
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NPI Number | 1770051484
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Entity Type | Organization
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Legal Business Name | OVERCOME WELLNESS & RECOVERY
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Dates
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Enumeration Date | 11/12/2018
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Last Update Date | 05/05/2023
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Provider Practice Location Address
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Address Line | 101 PROSPECT ST STE 210
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City | LAKEWOOD
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State | NJ
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Zip | 08701-5003
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Country | US
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Telephone | 732-505-7633
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Fax |
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Provider Business Mailing Address
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Address Line | 205 W PARKWAY DR
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City | EGG HARBOR TOWNSHIP
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State | NJ
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Zip | 08234-5105
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Country | US
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Telephone | 732-505-7633
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MR. ALEX KUSHNIR
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Credential |
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Telephone | 732-505-7633
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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