Organization
THE PASSION CARE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
OMAR RILEY (ACCOUNT MANAGER)
(267) 909-8264
Entity
Organization
Contact information
Practice address
187 FAYETTE ST, PERTH AMBOY, NJ 08861-4140
(267) 909-8264
(215) 525-0272
Mailing address
187 FAYETTE ST, PERTH AMBOY, NJ 08861-4140
(267) 909-8264
(215) 525-0272
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
NJ
2084P0800X
Psychiatry Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0398012
—
NJ
Enumeration date
05/21/2018
Last updated
05/21/2018
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