Organization
URBAN LIFE COUNSELING CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS JOHNSON (EXECUTIVE DIRECTOR)
(973) 677-7053
Entity
Organization
Contact information
Practice address
220 S HARRISON ST, EAST ORANGE, NJ 07018-1401
(973) 677-7053
(973) 677-7050
Mailing address
220 S HARRISON ST, EAST ORANGE, NJ 07018-1401
(973) 677-7053
(973) 677-7050
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
2000623
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0314111
—
NJ
05
—
0314129
—
NJ
Enumeration date
10/16/2017
Last updated
10/16/2017
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