BOYS & GIRLS CLUB OF NEWARK WELLNESS CENTER NPI 1164006797

NPI Information

NPI: 1164006797
Provider Name: BOYS & GIRLS CLUB OF NEWARK WELLNESS CENTER
Classification: Clinic/Center - 261QM0801X
Entity Type: Organization

Specialization: Mental Health (Including Community Mental Health Center)

Address:
1 AVON AVE
NEWARK, NJ
ZIP 07108
Phone: (973) 242-1200
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BOYS & GIRLS CLUB OF NEWARK WELLNESS CENTER is a mental health (including community mental health center) clinic center in Newark, NJ. BOYS & GIRLS CLUB OF NEWARK WELLNESS CENTER NPI is 1164006797. The provider is registered as an organization entity type.

The provider's business location address is:

1 AVON AVE
NEWARK, NJ
ZIP 07108-801
Phone: (973) 242-1200

The provider's authorized official is Gardan Speights .
The authorized official title is Director Of Community Wellness and has the following contact phone number (646) 236-5695.

The enumeration date for this NPI number is 5/10/2021 and was last updated on 12/13/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QM0801X	Clinic/Center	Mental Health (Including Community Mental Health Center)			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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