Provider Demographics
NPI:1679793434
Name:CENTER FOR PREVENTION & COUNSELING, INC
Entity type:Organization
Organization Name:CENTER FOR PREVENTION & COUNSELING, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:
Authorized Official - Last Name:ADOLPHE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-383-4787
Mailing Address - Street 1:61 SPRING ST
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:NEWTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07860-2072
Mailing Address - Country:US
Mailing Address - Phone:973-383-4787
Mailing Address - Fax:973-383-6576
Practice Address - Street 1:61 SPRING ST
Practice Address - Street 2:3RD FLOOR
Practice Address - City:NEWTON
Practice Address - State:NJ
Practice Address - Zip Code:07860-2072
Practice Address - Country:US
Practice Address - Phone:973-383-4787
Practice Address - Fax:973-383-6576
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ2000001324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0108120Medicaid