Organization
BALM IN GILEAD COMMUNITY SERVICES, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VIVA L WHITE LCSW (EXECUTIVE DIRECTOR)
(973) 517-4488
Entity
Organization
Contact information
Practice address
790 CLINTON AVE, NEWARK, NJ 07108-1047
(862) 235-0814
(973) 926-3577
Mailing address
PO BOX 28038, NEWARK, NJ 07101-1047
(973) 517-4488
(973) 926-3577
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
37CA00095399
NJ
1041C0700X
Clinical Social Worker
Primary
44SC05454500
NJ
Other
Enumeration date
04/19/2012
Last updated
09/06/2023
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