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General NPI Number Information
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NPI Number | 1770796575
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Entity Type | Organization
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Legal Business Name | IRON RECOVERY AND WELLNESS CENTER, INC.
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Dates
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Enumeration Date | 05/08/2007
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Last Update Date | 03/26/2025
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Provider Practice Location Address
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Address Line | 132 PERRY STREET
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City | TRENTON
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State | NJ
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Zip | 08618-3968
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Country | US
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Telephone | 609-394-8988
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Fax | 609-396-5856
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Provider Business Mailing Address
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Address Line | 132 PERRY STREET
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City | TRENTON
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State | NJ
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Zip | 08618-3968
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Country | US
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Telephone | 609-394-8988
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Fax | 609-396-5856
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MS. JESSICA BUZNEY
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Credential | LCADC
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Telephone | 609-394-8988
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 2000345
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 261QM2800X
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Taxonomy Name | Methadone Clinic
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License Number | NJ-10046-M
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License Number State | NJ
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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 | 2000345; 2000078
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License Number State | NJ
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Taxonomy #4
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number | 2000345
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License Number State | NJ
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