Provider Demographics
NPI:1659818730
Name:THE NEHEMIAH HOUSE OF RESTORATION, INC.
Entity Type:Organization
Organization Name:THE NEHEMIAH HOUSE OF RESTORATION, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROJECT DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ANNETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:RIVERA
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LPC, LCADC, ACS
Authorized Official - Phone:908-455-1027
Mailing Address - Street 1:416 W CANAL ST
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:PA
Mailing Address - Zip Code:18042-6245
Mailing Address - Country:US
Mailing Address - Phone:908-455-1027
Mailing Address - Fax:
Practice Address - Street 1:416 W CANAL ST
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:PA
Practice Address - Zip Code:18042-6245
Practice Address - Country:US
Practice Address - Phone:908-455-1027
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-26
Last Update Date:2017-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA487039324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility