Organization
THE PASSION CARE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELIEZER SANTIAGO MA, MBA (PRESIDENT)
(732) 410-7102
Entity
Organization
Contact information
Practice address
187 FAYETTE STREET, PERTH AMBOY, NJ 08861
(732) 410-7102
(732) 400-8503
Mailing address
187 FAYETTE STREET, PERTH AMBOY, NJ 08861
(732) 410-7102
(732) 400-8503
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
2000575
NJ
261QM0855X
Adolescent and Children Mental Health Clinic/Center
20005750575
NJ
Other
Enumeration date
10/28/2015
Last updated
10/28/2015
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