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Organization

RENAISSANCE CHALLENGE CONQUERER TRAINING CENTER INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. THOMAS REDDICK (PASTOR OWNER)
(973) 481-3431
Entity
Organization

Contact information

Practice address
400 7TH AVE W, NEWARK, NJ 07107-1697
(973) 481-3431
(973) 481-4142
Mailing address
400 7TH AVE W, NEWARK, NJ 07107-1697
(973) 481-3431
(973) 481-4142

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
PC003003
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0060356
NJ
Enumeration date
04/18/2007
Last updated
08/22/2020
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