Organization
CREATIVE INTERVENTION FOR MENTAL HEALTH AND CHEMICAL DEPENDENCY,PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LINDA GOCHFELD MD (MEDICAL DIRECTOR)
(609) 662-3096
Entity
Organization
Contact information
Practice address
1149 BLOOMFIELD AVE, CLIFTON, NJ 07012-2314
(973) 365-2300
(973) 365-0868
Mailing address
20 SCOTCH RD, EWING, NJ 08628-2503
(609) 406-0100
(609) 406-0307
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
000000
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000
MEDICARE PENDING
—
Enumeration date
03/30/2009
Last updated
03/27/2012
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