Organization
NORTH JERSEY AIDS ALLIANCE
Active
Organization
NORTH JERSEY AIDS ALLIANCE
Active
Other names
NJCRI
Organization subpart
No
Provider details
NPI number
Authorized official
COREY DESTEFANO (CLINICAL DIRECTOR)
(973) 483-3444
Entity
Organization
Contact information
Practice address
393 CENTRAL AVENUE C/O COREY DESTEFANO, NEWARK, NJ 07103
(973) 483-3444
(973) 648-0312
Mailing address
393 CENTRAL AVENUE C/O COREY DESTEFANO, NEWARK, NJ 07103
(973) 483-3444
(973) 648-0312
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
2000633
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0562343
—
NJ
Enumeration date
09/05/2017
Last updated
07/21/2022
Update your record
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