Organization
PORTUM WELLNESS AND RECOVERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ADEENA JACOBSON BCBA (CEO)
(917) 882-2744
Entity
Organization
Contact information
Practice address
1465 STATE ROUTE 31 S STE 1101, ANNANDALE, NJ 08801-3129
(551) 306-4000
Mailing address
1465 STATE ROUTE 31 S STE 1101, ANNANDALE, NJ 08801-3129
(551) 306-4000
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
Other
Enumeration date
04/14/2026
Last updated
04/14/2026
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