Provider Demographics
NPI:1114175080
Name:CENTER FOR AWARENESS & GROWTH, INC.
Entity Type:Organization
Organization Name:CENTER FOR AWARENESS & GROWTH, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR AND TREATING CLINICIAN
Authorized Official - Prefix:MS
Authorized Official - First Name:JOYCE
Authorized Official - Middle Name:L
Authorized Official - Last Name:MAUER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:973-783-8656
Mailing Address - Street 1:40 S FULLERTON AVE
Mailing Address - Street 2:
Mailing Address - City:MONTCLAIR
Mailing Address - State:NJ
Mailing Address - Zip Code:07042-3357
Mailing Address - Country:US
Mailing Address - Phone:973-783-8656
Mailing Address - Fax:
Practice Address - Street 1:40 S FULLERTON AVE
Practice Address - Street 2:
Practice Address - City:MONTCLAIR
Practice Address - State:NJ
Practice Address - Zip Code:07042-3357
Practice Address - Country:US
Practice Address - Phone:973-783-8656
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-04
Last Update Date:2008-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health