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Organization
GUIDED LIFE STRUCTURES
Active
Organization
GUIDED LIFE STRUCTURES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EILEEN OERTEL (EXECUTIVE DIRECTOR)
(908) 704-0011
Entity
Organization
Contact information
Practice address
75 VETERANS MEMORIAL DR E STE 205, SOMERVILLE, NJ 08876-2949
(908) 704-0011
(908) 704-0711
Mailing address
75 VETERANS MEMORIAL DR E STE 205, SOMERVILLE, NJ 08876-2949
(908) 704-0011
(908) 704-0711
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
2000133
NJ
324500000X
Substance Abuse Rehabilitation Facility
2000133
NJ
Other
Enumeration date
12/01/2017
Last updated
12/01/2017
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