Provider Demographics
NPI:1932604030
Name:COMMUNITY RECOVERY SVCS
Entity Type:Organization
Organization Name:COMMUNITY RECOVERY SVCS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:NIYA
Authorized Official - Middle Name:
Authorized Official - Last Name:BARAKA
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, LCADC
Authorized Official - Phone:973-698-2364
Mailing Address - Street 1:76 OAKMONT LN
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:NJ
Mailing Address - Zip Code:08527-4008
Mailing Address - Country:US
Mailing Address - Phone:973-449-1988
Mailing Address - Fax:
Practice Address - Street 1:23 GREEN TWIG DR
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08753-6846
Practice Address - Country:US
Practice Address - Phone:973-449-1988
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-29
Last Update Date:2018-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility