Organization
C-LINE COMMUNITY OUTREACH SERVICES
Active
Organization
C-LINE COMMUNITY OUTREACH SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CAROLINE NELSON (EXECUTIVE DIRECTOR)
(201) 200-1965
Entity
Organization
Contact information
Practice address
110 MARTIN LUTHER KING JR DR, JERSEY CITY, NJ 07305-3168
(201) 200-1965
(201) 200-1826
Mailing address
PO BOX 15802, JERSEY CITY, NJ 07305-0802
(201) 200-1965
(201) 200-1826
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
37LC00116800
NJ
101YM0800X
Mental Health Counselor
44SC05375200
NJ
261QM1300X
Multi-Specialty Clinic/Center
Primary
2000071
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0352233
—
NJ
Enumeration date
05/04/2011
Last updated
05/21/2014
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