| Elite Nu Diamond, Inc. | |
|
15 Brinkerhoff St Jersey City NJ 07304-2922 | |
| (201) 654-4530 | |
| Not Available |
| Full Name | Elite Nu Diamond, Inc. |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 15 Brinkerhoff St, Jersey City, New Jersey |
| Authorized Official Name and Position | Ayeisha C Robinson (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 9084566687 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Elite Nu Diamond, Inc. 482 Ocean Ave Jersey City NJ 07305-3321 Ph: (201) 852-7887 | Elite Nu Diamond, Inc. 15 Brinkerhoff St Jersey City NJ 07304-2922 Ph: (201) 654-4530 |
| NPI Number | 1063939908 |
|---|---|
| Provider Enumeration Date | 08/22/2017 |
| Last Update Date | 08/22/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063939908 | NPI | - | NPPES |
| 00000000000000000000 | Medicaid | NJ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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