Organization
AUTONOME COUNSELING CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ADAM WESLEY THOMAS LPC (OWNER/SUPERVISOR)
(201) 743-8052
Entity
Organization
Contact information
Practice address
60 LENAPE TRL, BRICK, NJ 08724-4453
(201) 743-8052
(732) 612-1273
Mailing address
60 LENAPE TRL, BRICK, NJ 08724-4453
(201) 743-8052
(732) 612-1273
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
37PC00502900
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0564923
—
NJ
Enumeration date
10/13/2017
Last updated
06/16/2018
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