Provider Demographics
NPI:1639692056
Name:AMOS CENTER FOR WELLNESS AND RECOVERY
Entity Type:Organization
Organization Name:AMOS CENTER FOR WELLNESS AND RECOVERY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:ASSAF
Authorized Official - Middle Name:
Authorized Official - Last Name:AMOS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW, LCADC, MSW
Authorized Official - Phone:201-817-9962
Mailing Address - Street 1:PO BOX 3145
Mailing Address - Street 2:
Mailing Address - City:TEANECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07666-9103
Mailing Address - Country:US
Mailing Address - Phone:201-817-9962
Mailing Address - Fax:
Practice Address - Street 1:773 TEANECK RD
Practice Address - Street 2:
Practice Address - City:TEANECK
Practice Address - State:NJ
Practice Address - Zip Code:07666-4846
Practice Address - Country:US
Practice Address - Phone:201-817-9962
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-18
Last Update Date:2017-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC05730200261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health