Organization
BODHI AWAKEN TO RECOVERY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JASON WHEELER (ACCOUNT MANAGER)
(954) 802-9568
Entity
Organization
Contact information
Practice address
1466 HOOPER AVE, TOMS RIVER, NJ 08753-2892
(732) 443-7324
Mailing address
48 PINYON ST, HOWELL, NJ 07731-2812
(732) 443-7324
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
44SW01474300
NJ
Other
Enumeration date
09/05/2014
Last updated
09/05/2014
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