Organization
COLEMAN ADDICTION MEDICINE, P.C.
Active
Organization
COLEMAN ADDICTION MEDICINE, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GENCO D'ANDRIA (CFO)
(214) 379-3300
Entity
Organization
Contact information
Practice address
23-00 STATE RT 208 STE 1-1, FAIR LAWN, NJ 07410-1558
(617) 996-8365
Mailing address
1720 LAKEPOINTE DR STE 117, LEWISVILLE, TX 75057-6425
(214) 379-3300
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
324500000X
Substance Abuse Rehabilitation Facility
—
—
Other
Enumeration date
06/19/2019
Last updated
01/13/2021
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