Organization
COLLEGE RECOVERY LLC
Active
Parent organization
COLLEGE RECOVERY LLC
Other names
SOBA New Jersey
Organization subpart
Yes
Provider details
NPI number
Legal business name
COLLEGE RECOVERY LLC
Authorized official
ISAAC GLASMAN (DIRECTOR)
(973) 556-7701
Entity
Organization
Contact information
Practice address
104 BAYARD ST, NEW BRUNSWICK, NJ 08901-2389
(973) 556-7701
Mailing address
104 BAYARD ST, NEW BRUNSWICK, NJ 08901-2389
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
324500000X
Substance Abuse Rehabilitation Facility
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2000540
DOH CN&L
NJ
Enumeration date
08/07/2024
Last updated
08/07/2024
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