Organization
RENAISSANCE CHALLENGE CONQUERER TRAINING CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. THOMAS REDDICK (OWNER)
(973) 481-3431
Entity
Organization
Contact information
Practice address
400 7TH AVE, NEWARK, NJ 07107-1697
(973) 481-3431
Mailing address
400 7TH AVE, NEWARK, NJ 07107-1697
(973) 481-3431
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
PC003003
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0056391
—
NJ
Enumeration date
06/07/2006
Last updated
01/24/2008
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