Provider First Line Business Practice Location Address:
385 TREMONT AVE
Provider Second Line Business Practice Location Address:
METHADONE CLINIC 15A
Provider Business Practice Location Address City Name:
EAST ORANGE
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07018-1023
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
973-676-1000
Provider Business Practice Location Address Fax Number:
973-395-7254
Provider Enumeration Date:
09/03/2006