Organization
HEALTHY TRANSITIONS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DIANE BRUESSOW PA (MANAGING MEMBER)
(908) 647-1688
Entity
Organization
Contact information
Practice address
50 CHURCH ST STE L3, MONTCLAIR, NJ 07042-2772
(908) 647-1688
(908) 647-1688
Mailing address
50 CHURCH ST STE L3, MONTCLAIR, NJ 07042-2772
(908) 647-1688
(908) 647-1688
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
25MA05818600
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
25MA05818600
LICENSE
NJ
Enumeration date
10/23/2007
Last updated
04/08/2024
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