Organization
MCG BH PACT PROGRAM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARITY O EZEALA (RN)
(973) 466-1351
Entity
Organization
Contact information
Practice address
269 OLIVER ST, NEWARK, NJ 07105-2507
(973) 466-1351
Mailing address
1 CARPENTER RD, PISCATAWAY, NJ 08854-5280
(732) 650-1401
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
26NR09838600
NJ
Other
Enumeration date
04/02/2007
Last updated
08/22/2020
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