SOUL HOUSE CRUBER WELLNESS CENTER (NPI# 1245754084) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245754084 |
| Entity Type | Organization |
| Organization Name | SOUL HOUSE CRUBER WELLNESS CENTER |
| Practice Address |
1144 Clinton Avenue Irvington NJ 07111 |
| Mailing Address |
1144 Clinton Ave Irvington NJ 07111-2045 |
| Practice Telephone | (862) 218-6710 |
| Practice Fax Number | 9733993613 |
| Mailing Telephone | 8622186710 |
| Mailing Fax Number | 9733993613 |
| Enumeration Date | 2017-08-02 |
| Last Update Date | 2017-08-02 |
| Authorized Official Name | MR. ALI RASHID (CHIEF FINANCIAL OFFICER) |
| Authorized Official Telephone | 9733993100 |
| Authorized Official Credential | MBA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
37LC00170100 | NJ | Behavioral Health & Social Service Providers |
| Street Address |
1144 CLINTON AVENUE |
| City | IRVINGTON |
| State | NJ |
| Zip Code | 07111 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548871163 | Le Choix Home Care LLC | Home Health | 1395-1399 Clinton Ave, Irvington, NJ 07111 | 2020-08-17 |
| 1528532447 | All America Medical Day Care | Custodial Care Facility | 141 Coit St, Irvington, NJ 07111 | 2019-01-14 |
| 1548737240 | Irvington Adult Day Care Center | Clinic/Center | 62-70 Howard Street, Irvington, NJ 07111 | 2018-10-31 |
| 1689194094 | Anthony Ijehsedeh | Nurse Practitioner | 12 Krotik Place, Irvington, NJ 07111 | 2017-06-27 |
| 1467993246 | Sia Kendema | Respite Care | 102 Paine Avenue, Irvington, NJ 07111 | 2017-03-14 |
| 1316482078 | Walgreen Co | Pharmacy | 810 Springfield Ave, Irvington, NJ 07111 | 2017-01-04 |
| 1679023915 | Lyons Pharmacy | Pharmacy | 471 Lyons Ave #79, Irvington, NJ 07111 | 2016-10-11 |
| 1952759276 | Sabreehouse | Community/Behavioral Health | 74 Welland Avenue, Irvington, NJ 07111 | 2016-05-26 |
| 1447624184 | Marius Nzo Yonkeu | Pharmacist | 19 Bruen Ave Apt C1, Irvington, NJ 07111 | 2015-11-18 |
| 1801265251 | Jerrilynn Mccray | Case Management | 12 Momm Court, Irvington, NJ 07111 | 2015-09-16 |
| Find all providers in zip 07111 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447730411 | Mustafa Shakir Abdus-salaam | Counselor | 19 Orange Pl, Irvington, NJ 07111-2019 | 2018-08-18 |
| 1033624721 | Roderick A. Murphy | Counselor | 123 22nd St Apt 2, Irvington, NJ 07111-4421 | 2017-12-05 |
| 1134677248 | Lynne Chantel Holley | Counselor | 50 Union Ave Ste 804b, Irvington, NJ 07111-5221 | 2016-09-17 |
| 1902045784 | Tammy O Freeman | Counselor | 96 Coolidge St, Irvington, NJ 07111 | 2009-02-18 |
| 1457905515 | Murphy Counseling & Counsulting LLC | Counselor | 123 22nd St Apt 2, Irvington, NJ 07111-4421 | 2019-07-27 |
| 1417479056 | Phoenix Risings Counseling Center LLC | Counselor | 50 Union Ave Ste 804b, Irvington, NJ 07111-5221 | 2017-07-14 |
| 1124004254 | Mary Therese Harrington | Counselor | 1 Bridge St, Suite 22, Irvington, NY 10533-1543 | 2005-12-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083212617 | Jeanette Roma | Counselor | 340 U S 9, Bayville, NJ 08721-0872 | 2020-10-15 |
| 1467069963 | Caitlyn Higgins | Counselor | 6 Hemlock Ln, Marlboro, NJ 07746-1213 | 2020-09-28 |
| 1225643760 | Lorianne Toth | Counselor | 11 Beckett St, Clayton, NJ 08312-2408 | 2020-09-11 |
| 1043823263 | Ramona Leclaire | Counselor | 111 Rte 35, Cliffwood, NJ 07721-1512 | 2020-08-27 |
| 1114539996 | Edward Michael Cunningham | Counselor | 6 Bently Dr, Sewell, NJ 08080-1827 | 2020-08-21 |
| 1043821697 | Margarette Charles | Counselor | 180 Tices Ln Ste 202, East Brunswick, NJ 08816-1345 | 2020-08-16 |
| 1306457866 | Brooke Aymes | Counselor | 1 E Lakeview Ave, Oaklyn, NJ 08107-1346 | 2020-08-10 |
| 1447869441 | Olivia Benoit | Counselor | 623 English Ct, South Plainfield, NJ 07080-2339 | 2020-07-24 |
| 1487272431 | Alexandra Knight | Counselor | 306 Washington St Ste 303&304, Hoboken, NJ 07030-5162 | 2020-07-07 |
| 1285252296 | Gage Blanck-singer | Counselor | 115 Old Short Hills Rd Apt 563, West Orange, NJ 07052-1048 | 2020-07-07 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on SOUL HOUSE CRUBER WELLNESS CENTER.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.