Organization
INNOVATIVE LEARNING GROUP
Active
Organization
INNOVATIVE LEARNING GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARICRUZ CASTILLO (EXECUTIVE DIRECTOR)
(973) 886-8768
Entity
Organization
Contact information
Practice address
29 GARDEN AVE, HAWTHORNE, NJ 07506-1518
(973) 886-8768
Mailing address
PO BOX 396, HAWTHORNE, NJ 07507-0396
(973) 886-8768
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
1-10-7128
NJ
Other
Enumeration date
01/20/2011
Last updated
01/20/2011
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