C-LINE COMMUNITY OUTREACH SERVICES NPI 1336431675

NPI Information

NPI: 1336431675
Provider Name: C-LINE COMMUNITY OUTREACH SERVICES
Classification: Clinic/Center - 261QM1300X
Entity Type: Organization

Specialization: Multi-Specialty

Address:
110 MARTIN LUTHER KING JR DR
JERSEY CITY, NJ
ZIP 07305
Phone: (201) 200-1965
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C-LINE COMMUNITY OUTREACH SERVICES is a multi-specialty clinic center in Jersey City, NJ. C-LINE COMMUNITY OUTREACH SERVICES NPI is 1336431675. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

110 MARTIN LUTHER KING JR DR
JERSEY CITY, NJ
ZIP 07305-168
Phone: (201) 200-1965
Fax: (201) 200-1826

The provider's authorized official is Caroline Nelson .
The authorized official title is Executive Director and has the following contact phone number (201) 200-1965.

The enumeration date for this NPI number is 5/4/2011 and was last updated on 5/21/2014.

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	101YA0400X	Counselor	Addiction (Substance Use Disorder)	37LC00116800	NEW JERSEY	No
2	101YM0800X	Counselor	Mental Health	44SC05375200	NEW JERSEY	No
3	261QM1300X	Clinic/Center	Multi-Specialty	2000071	NEW JERSEY	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	032809	MEDICARE UPIN	NEW JERSEY
2	0352233	MEDICAID	NEW JERSEY

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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