Organization
IGNITE TEEN TREATMENT, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALAN BOND (CFO)
(310) 774-1303
Entity
Organization
Contact information
Practice address
270 DAVIDSON AVE STE 105, SOMERSET, NJ 08873-4141
(570) 203-9222
(570) 203-9477
Mailing address
270 PIERCE ST STE 208, KINGSTON, PA 18704-5141
(570) 203-9222
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
10/25/2021
Last updated
10/25/2021
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