| Iron Sport Llc | |
|
65 46th St Apt 2 Weehawken NJ 07086-7168 | |
| (310) 463-1782 | |
| Not Available |
| Full Name | Iron Sport Llc |
|---|---|
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 65 46th St Apt 2, Weehawken, New Jersey |
| Authorized Official Name and Position | Wesley Michael Gober (FOUNDER) |
| Authorized Official Contact | 3104631782 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Iron Sport Llc 65 46th St Apt 2 Weehawken NJ 07086-7168 Ph: (310) 463-1782 | Iron Sport Llc 65 46th St Apt 2 Weehawken NJ 07086-7168 Ph: (310) 463-1782 |
| NPI Number | 1811487911 |
|---|---|
| Provider Enumeration Date | 05/14/2018 |
| Last Update Date | 01/29/2024 |
| Certification Date | 01/29/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811487911 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Primary |
| 324500000X | Substance Abuse Rehabilitation Facility | (* (Not Available)) | Secondary |
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