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Organization

COLLEGE RECOVERY LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. ISAAC GLASMAN (DIRECTOR)
(817) 806-9662
Entity
Organization

Contact information

Practice address
23 DUKE ST, NEW BRUNSWICK, NJ 08901-1738
(732) 402-0677
(732) 626-6797
Mailing address
104 BAYARD ST, SUITE 1, NEW BRUNSWICK, NJ 08901-2102
(917) 806-9662

Taxonomy

Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
324500000X
Substance Abuse Rehabilitation Facility
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1000153
DEPT OF HUMAN SERVICES
NJ
01
2000540
DEPT OF HUMAN SERVICES
NJ
Enumeration date
08/22/2014
Last updated
10/27/2022
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