Organization
THERACARE OF NEW JERSEY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN CALDERON (PRESIDENT)
(212) 564-2350
Entity
Organization
Contact information
Practice address
67 WALNUT AVE, SUITE 306, CLARK, NJ 07066-1640
(888) 311-2611
Mailing address
67 WALNUT AVE, SUITE 306, CLARK, NJ 07066-1640
(888) 311-2611
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0038679
—
NJ
Enumeration date
01/30/2007
Last updated
12/11/2007
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