Organization
EVA'S VILLAGE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VITO ANDRISANI LCADC (EXECUTIVE VICE PRESIDENT)
(973) 523-6220
Entity
Organization
Contact information
Practice address
20 JACKSON STREET, PATERSON, NJ 07501-2815
(973) 523-6220
(973) 825-7297
Mailing address
393 MAIN ST, PATERSON, NJ 07501-2815
(973) 523-6220
(973) 825-7297
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
687359
—
NJ
Enumeration date
01/09/2019
Last updated
04/12/2021
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