Organization
KWENYAN PROFESSIONAL HEALTH SERVICES, LLC
Active
Organization
KWENYAN PROFESSIONAL HEALTH SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DANIEL CASSELL MA, MPH, LPC, LCADC, (PRESIDENT/CEO)
(973) 672-6900
Entity
Organization
Contact information
Practice address
60 EVERGREEN PL, SUITE 500, EAST ORANGE, NJ 07018-2106
(973) 672-6901
(866) 376-8262
Mailing address
60 EVERGREEN PL, SUITE 500, EAST ORANGE, NJ 07018-2106
(973) 672-6901
(866) 376-8262
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
2000479-10
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0226220
—
NJ
Enumeration date
06/02/2010
Last updated
06/02/2011
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