Provider Demographics
NPI:1972168482
Name:NEWARK RENAISSANCE HOUSE, INC
Entity Type:Organization
Organization Name:NEWARK RENAISSANCE HOUSE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP/COO
Authorized Official - Prefix:
Authorized Official - First Name:MARIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHRECK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-202-0870
Mailing Address - Street 1:PO BOX 7057
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07107-0057
Mailing Address - Country:US
Mailing Address - Phone:973-854-8313
Mailing Address - Fax:973-623-8877
Practice Address - Street 1:50-56 NORFOLK STREET
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07103
Practice Address - Country:US
Practice Address - Phone:973-854-8313
Practice Address - Fax:973-623-8877
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-09
Last Update Date:2019-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes276400000XHospital UnitsRehabilitation, Substance Use Disorder Unit