Organization
PASSION CARE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ELIEZER SANTIAGO M.A., M.B.A. (PROGRMA ADMINISTRATOR)
(732) 410-7102
Entity
Organization
Contact information
Practice address
187 FAYETTE STREET, PERTH AMBOY, NJ 08861
(732) 410-7102
(732) 400-8503
Mailing address
187 FAYETTE STREET, PERTH AMBOY, NJ 08861
(732) 410-7102
(732) 400-8503
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
2000575
NJ
Other
Enumeration date
11/04/2013
Last updated
01/17/2019
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