Provider Demographics
NPI:1265122048
Name:NIJAH THERAPEUTIC SERVICES
Entity type:Organization
Organization Name:NIJAH THERAPEUTIC SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ZANNIAH
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES GLOVER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-676-3736
Mailing Address - Street 1:PO BOX 180
Mailing Address - Street 2:
Mailing Address - City:NEPTUNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07754-0180
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:704 OHAGEN TER
Practice Address - Street 2:
Practice Address - City:NEPTUNE
Practice Address - State:NJ
Practice Address - Zip Code:07753-2830
Practice Address - Country:US
Practice Address - Phone:732-676-3736
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-15
Last Update Date:2023-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty