Organization
NEWLY DESTINED, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RUBEN JOHNSON SR. (CEO)
(973) 477-7639
Entity
Organization
Contact information
Practice address
920 BROAD ST # 1114, NEWARK, NJ 07102-2660
(973) 242-8088
(973) 242-8069
Mailing address
1114 BROAD STREET, NEWARK, NJ 07102
(973) 242-8088
(973) 242-8069
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
04/10/2009
Last updated
04/10/2009
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