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General NPI Number Information
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NPI Number | 1942040480
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Entity Type | Organization
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Legal Business Name | ARBOR INTEGRATIVE SERVICES LLC
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Dates
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Enumeration Date | 05/31/2024
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Last Update Date | 06/04/2024
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Provider Practice Location Address
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Address Line | 42 MARLEY AVE
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City | CEDAR GROVE
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State | NJ
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Zip | 07009-1139
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Country | US
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Telephone | 973-903-1613
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Fax |
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Provider Business Mailing Address
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Address Line | 42 MARLEY AVE
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City | CEDAR GROVE
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State | NJ
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Zip | 07009-1139
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Country | US
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Telephone | 973-903-1613
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | ASHLEY SAN GIACOMO
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Credential | LCSW
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Telephone | 973-903-1613
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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