Organization
GREAT EXPECTATIONS CLINICAL AND SUPPORT SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROMAN RUBIN (CHIEF EXECUTIVE OFFICE)
(917) 816-4948
Entity
Organization
Contact information
Practice address
263 HILLSIDE AVE, SUITE 6, NUTLEY, NJ 07110-1180
(917) 816-4948
Mailing address
263 HILLSIDE AVE, SUITE 6, NUTLEY, NJ 07110-1180
(917) 816-4948
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
04/05/2017
Last updated
04/05/2017
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