Provider Demographics
NPI:1013157593
Name:TRINITY UAME CHURCH
Entity Type:Organization
Organization Name:TRINITY UAME CHURCH
Other - Org Name:PRESS TOWARD THE MARK
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PROGRAM COORDINATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:DIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:JERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:CDA
Authorized Official - Phone:973-230-1633
Mailing Address - Street 1:226-230 WARREN ST
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07103-3530
Mailing Address - Country:US
Mailing Address - Phone:973-230-1633
Mailing Address - Fax:973-230-2890
Practice Address - Street 1:226-230 WARREN ST
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07103-3530
Practice Address - Country:US
Practice Address - Phone:973-230-1633
Practice Address - Fax:973-230-2890
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-24
Last Update Date:2009-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ2000072-09261QR0405X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder