MEDICARE: SAINT JAMES HEALTH, 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

General Provider Information

NPI Number	:	1780068668
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SAINT JAMES HEALTH, INC

Provider Business Mailing Address
First Line	:	500 AVENUE P
Second Line	:
City	:	NEWARK
State	:	NJ
Zip	:	07105-4802
Country	:	US
Telephone Number	:	908-578-7273
Fax Number	:

Provider Business Practice Location Address
First Line	:	99 MADISON ST
Second Line	:
City	:	NEWARK
State	:	NJ
Zip	:	07105-2107
Country	:	US
Telephone Number	:	908-578-7273
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MS. NICOLE MARIE FIELDS
Credential	:
Telephone Number	:	908-578-7273

Provider Enumeration Date	:	07/10/2015
Last Update Date	:	07/10/2015

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