Provider Demographics
NPI:1922353572
Name:IRON RECOVERY AND WELLNESS CENTER, INC.
Entity Type:Organization
Organization Name:IRON RECOVERY AND WELLNESS CENTER, INC.
Other - Org Name:NEW HORIZON TREATMENT SERVICES, INC- MENTAL HEALTH/ADVANCED COUNSELING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:
Authorized Official - Last Name:WOLFE
Authorized Official - Suffix:
Authorized Official - Credentials:MA, CAADC, ICAADC
Authorized Official - Phone:609-394-8988
Mailing Address - Street 1:144 PERRY STREET
Mailing Address - Street 2:
Mailing Address - City:TRENTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08618-3968
Mailing Address - Country:US
Mailing Address - Phone:609-394-8988
Mailing Address - Fax:609-396-5856
Practice Address - Street 1:144 PERRY ST
Practice Address - Street 2:
Practice Address - City:TRENTON
Practice Address - State:NJ
Practice Address - Zip Code:08618-3968
Practice Address - Country:US
Practice Address - Phone:609-394-8988
Practice Address - Fax:609-599-1561
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NEW HORIZON TREATMENT SERVICES, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-07-19
Last Update Date:2020-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ96503-01-04261QM0801X
261QM1300X
NJ2000078-08261QR0405X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ96503-01-04OtherN.J. DEPT. HUMAN SERVICES
NJ0372331Medicaid