Provider Demographics
NPI:1467748012
Name:STRAIGHT AND NARROW, INC.
Entity Type:Organization
Organization Name:STRAIGHT AND NARROW, INC.
Other - Org Name:DETOX/ LONG TERM
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:J
Authorized Official - Last Name:MACTAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-345-6000
Mailing Address - Street 1:396 STRAIGHT ST
Mailing Address - Street 2:
Mailing Address - City:PATERSON
Mailing Address - State:NJ
Mailing Address - Zip Code:07501-2921
Mailing Address - Country:US
Mailing Address - Phone:973-345-6000
Mailing Address - Fax:973-345-7279
Practice Address - Street 1:396 STRAIGHT ST
Practice Address - Street 2:
Practice Address - City:PATERSON
Practice Address - State:NJ
Practice Address - Zip Code:07501-2921
Practice Address - Country:US
Practice Address - Phone:973-345-6000
Practice Address - Fax:973-345-7279
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:STRAIGHT AND NARROW, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-06-22
Last Update Date:2011-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ1000065324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0236250Medicaid