Provider Demographics
NPI:1205386745
Name:JUVENILE & ADULT RE-ENTRY CONNECTIONS
Entity Type:Organization
Organization Name:JUVENILE & ADULT RE-ENTRY CONNECTIONS
Other - Org Name:JARC
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:DIONE
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:609-917-8268
Mailing Address - Street 1:300 CARNEGIE CTR
Mailing Address - Street 2:SUITE 150
Mailing Address - City:PRINCETON
Mailing Address - State:NJ
Mailing Address - Zip Code:08540-6249
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:300 CARNEGIE CTR
Practice Address - Street 2:SUITE 150
Practice Address - City:PRINCETON
Practice Address - State:NJ
Practice Address - Zip Code:08540-6249
Practice Address - Country:US
Practice Address - Phone:609-917-8268
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-07
Last Update Date:2016-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35SI00519000251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health