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NPI Code Detail

MEDICARE: OVERCOME WELLNESS & RECOVERY

MEDICARE: OVERCOME WELLNESS & RECOVERY
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
1261QR0405XSubstance Use Disorder Rehabilitation Clinic/Center

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
12000913OTHERNJSTATE OF N E W JERSEY DEPARTMENT OF HEALTH DIVISION OF CERTIFICATE OF NEED& LICE

General Provider Information

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

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Directions to “OVERCOME WELLNESS & RECOVERY ” Practice Location

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