Organization · Type 2 NPI

City of East Orange

Methadone Clinic · East Orange, NJ

NPI number 1487888145 Active

Practice location

110 South Grove Street, 3rd Floor
East Orange, NJ 07018

Fax (973) 678-6843

Specialties and licenses

Taxonomy	Code	License
Addiction (Substance Use Disorder) Counselor	101YA0400X	None listed
Clinical Social Worker	1041C0700X	None listed
Nutrition Education Nutritionist	133NN1002X	None listed
Psychiatry Physician	2084P0800X	None listed
Methadone Clinic Primary	261QM2800X	None listed

Methadone Clinic: An entity, facility, or distinct part of a facility providing diagnostic, and replacement maintenance treatment services related to individuals with drug addiction.

NPI record

NPI: 1487888145
Entity type: Organization (Type 2)
Issued: May 11, 2009
Last updated: Jan 16, 2020
Status: Active
Subpart: Yes of City of East Orange

Other names

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East Orange Substance Abuse Treatment Program · doing business as

Authorized official

Ms. Yvonne C. Blake
Director
(973) 266-5200

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1487888145

City of East Orange's National Provider Identifier is 1487888145, issued on May 11, 2009. The primary taxonomy on file is Methadone Clinic (261QM2800X), and the practice location is in East Orange, NJ. The record was last updated on Jan 16, 2020.