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Organization

INTERNAL AFFAIRS TREATMENT GROUP

Active
Parent organization
COBAR LLC
Organization subpart
Yes

Provider details

NPI number
Legal business name
COBAR LLC
Authorized official
GREGORY INGRAM LCSW (CEO/EXECUTIVE DIRECTOR)
(908) 422-5340
Entity
Organization

Contact information

Practice address
198 NORTH AVE E, CRANFORD, NJ 07016-2469
(908) 422-5340
Mailing address
210 E 2ND AVE, ROSELLE, NJ 07203-1306
(908) 422-5340

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
44SC05532900
NJ

Other

Enumeration date
10/07/2016
Last updated
10/07/2016
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