Organization
ELITE NU DIAMOND, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AYEISHA C ROBINSON MA (EXECUTIVE DIRECTOR)
(908) 456-6687
Entity
Organization
Contact information
Practice address
15 BRINKERHOFF ST, JERSEY CITY, NJ 07304-2922
(201) 654-4530
Mailing address
482 OCEAN AVE, JERSEY CITY, NJ 07305-3321
(201) 852-7887
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00000000000000000000
—
NJ
Enumeration date
08/22/2017
Last updated
08/22/2017
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