Provider Demographics
NPI:1669998100
Name:SEACREST RECOVERY CENTER NORTH JERSEY, LLC
Entity type:Organization
Organization Name:SEACREST RECOVERY CENTER NORTH JERSEY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JARED
Authorized Official - Middle Name:
Authorized Official - Last Name:PRUZAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-415-3608
Mailing Address - Street 1:5300 ATLANTIC AVE STE 400
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33484-8141
Mailing Address - Country:US
Mailing Address - Phone:954-415-3608
Mailing Address - Fax:
Practice Address - Street 1:162 N MAIN STREET
Practice Address - Street 2:ROUTE 35
Practice Address - City:EATONTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07724
Practice Address - Country:US
Practice Address - Phone:954-415-3608
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-16
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
No103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup PsychotherapyGroup - Multi-Specialty