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Organization

INTERSTATE FACTS, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. KATHRYN A DIXON LCSW (EXECUTIVE DIRECTOR)
(201) 488-5188
Entity
Organization

Contact information

Practice address
238 MAIN ST, SUITE 102, HACKENSACK, NJ 07601-7323
(201) 488-5188
(201) 488-5189
Mailing address
238 MAIN ST, SUITE 102, HACKENSACK, NJ 07601-7323
(201) 488-5188
(201) 488-5189

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
44SC01011300
NJ

Other

Enumeration date
02/19/2009
Last updated
02/19/2009
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