Organization
CLEAR CHOICE BEHAVIORAL HEALTHCARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSE DE LA CRUZ BA (PROVIDER)
(973) 510-4089
Entity
Organization
Contact information
Practice address
61 FENNER AVE, CLIFTON, NJ 07013-1049
(973) 510-4089
Mailing address
61 FENNER AVE, CLIFTON, NJ 07013-1049
(973) 510-4089
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
596-56-2994
MEDICARE
—
Enumeration date
03/01/2019
Last updated
03/01/2019
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