| Grounding Root Therapy LLC | |
|
1060 Main St Ste 200a River Edge NJ 07661-2591 | |
| (973) 876-6902 | |
| Not Available |
| Full Name | Grounding Root Therapy LLC |
|---|---|
| Speciality | Counselor |
| Location | 1060 Main St Ste 200a, River Edge, New Jersey |
| Authorized Official Name and Position | Michael Mariano (OWNER) |
| Authorized Official Contact | 9738766902 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Grounding Root Therapy LLC 1060 Main St Ste 200a River Edge NJ 07661-2591 Ph: (973) 876-6902 | Grounding Root Therapy LLC 1060 Main St Ste 200a River Edge NJ 07661-2591 Ph: (973) 876-6902 |
| NPI Number | 1033629167 |
|---|---|
| Provider Enumeration Date | 10/03/2017 |
| Last Update Date | 07/01/2020 |
| Certification Date | 07/01/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033629167 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | () | Primary |
| 324500000X | Substance Abuse Rehabilitation Facility | 37LC00237300 (New Jersey) | Secondary |
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