MEDICARE: RESOLVE COMMUNITY COUNSELING CENTER, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency	100940104	NJ

General Provider Information

NPI Number	:	1205081510
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RESOLVE COMMUNITY COUNSELING CENTER, INC.

Provider Business Mailing Address
First Line	:	1830 FRONT ST
Second Line	:
City	:	SCOTCH PLAINS
State	:	NJ
Zip	:	07076-1103
Country	:	US
Telephone Number	:	908-322-9180
Fax Number	:	908-322-9094

Provider Business Practice Location Address
First Line	:	1830 FRONT ST
Second Line	:
City	:	SCOTCH PLAINS
State	:	NJ
Zip	:	07076-1103
Country	:	US
Telephone Number	:	908-322-9180
Fax Number	:	908-322-9094

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	DR. LIDIA D ABRAMS
Credential	:	PHD
Telephone Number	:	908-322-9180

Provider Enumeration Date	:	12/01/2008
Last Update Date	:	12/01/2008

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