OrganizationActive
Northeast Life Skills Associates, Inc.
NPI 1093707192 · Methadone Clinic · Passaic, NJ
Provider details
- NPI number
- 1093707192
- Entity type
- Organization
- Primary specialty
- Methadone ClinicAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Carolyn Illge, Executive Director(973) 777-2962
- License
- 10CC00058000 (NJ)
Specialties & taxonomies
Ambulatory Health Care Facilities
Ambulatory Health Care Facilities
Practice location
121 Howe Ave
Passaic, NJ 07055-4013
Phone: (973) 777-2962
Fax: (973) 777-7623
Approximate (ZIP-level) locationGet directions
Mailing address
121 Howe Ave
Passaic, NJ 07055-4013
Other names (DBA / former)
- Former legal business name
- The Passaic Clinic
Registry dates
- Enumerated
- 2005-08-16
- Last updated
- 2020-08-22
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.