Soul House Cruber Wellness Center

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

37LC00170100 Issued in NJ

Legal business name

SOUL HOUSE CRUBER WELLNESS CENTER

Practice address

1144 Clinton Avenue
Irvington, NJ 07111

Phone

(862) 218-6710

Fax

(973) 399-3613

NPI assigned

Aug 2, 2017

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Ali Rashid, MBA

Title

Chief Financial Officer

Phone

(973) 399-3100

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1501632000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1245754084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1144 CLINTON AVE",
            "city": "IRVINGTON",
            "state": "NJ",
            "postal_code": "071112045",
            "telephone_number": "862-218-6710",
            "fax_number": "973-399-3613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1144 CLINTON AVENUE",
            "city": "IRVINGTON",
            "state": "NJ",
            "postal_code": "07111",
            "telephone_number": "862-218-6710",
            "fax_number": "973-399-3613"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUL HOUSE CRUBER WELLNESS CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-02",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "RASHID",
        "authorized_official_first_name": "ALI",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "973-399-3100",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NJ",
            "license": "37LC00170100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Addiction (Substance Use Disorder) Counselor in Irvington, NJ
• Providers in Irvington, NJ by specialty
• Addiction (Substance Use Disorder) Counselor in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.