| Soul House Cruber Wellness Center | |
| 
					1144 Clinton Avenue Irvington NJ 07111  | |
| (862) 218-6710 | |
| (973) 399-3613 | 
| Full Name | Soul House Cruber Wellness Center | 
|---|---|
| Speciality | Counselor - Addiction (substance Use Disorder) | 
| Location | 1144 Clinton Avenue, Irvington, New Jersey | 
| Authorized Official Name and Position | Ali Rashid (CHIEF FINANCIAL OFFICER) | 
| Authorized Official Contact | 9733993100 | 
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. | 
| Mailing Address | Practice Location Address | 
|---|---|
| Soul House Cruber Wellness Center 1144 Clinton Ave Irvington NJ 07111-2045 Ph: (862) 218-6710  | Soul House Cruber Wellness Center 1144 Clinton Avenue Irvington NJ 07111 Ph: (862) 218-6710  | 
| NPI Number | 1245754084 | 
|---|---|
| Provider Enumeration Date | 08/02/2017 | 
| Last Update Date | 07/21/2022 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1245754084 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 37LC00170100 (New Jersey) | Primary | 
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