Provider Demographics
NPI:1447313861
Name:HUNTERDON DRUG AWARENESS PROGRAM, INC.
Entity type:Organization
Organization Name:HUNTERDON DRUG AWARENESS PROGRAM, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:GLENN
Authorized Official - Middle Name:
Authorized Official - Last Name:DUNCAN
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, LCADC, CCS, ACS
Authorized Official - Phone:908-788-1900
Mailing Address - Street 1:8 MAIN ST STE 7
Mailing Address - Street 2:
Mailing Address - City:FLEMINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08822-1468
Mailing Address - Country:US
Mailing Address - Phone:908-788-1900
Mailing Address - Fax:908-788-3836
Practice Address - Street 1:8 MAIN ST STE 7
Practice Address - Street 2:
Practice Address - City:FLEMINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08822-1468
Practice Address - Country:US
Practice Address - Phone:908-788-1900
Practice Address - Fax:908-788-3836
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-18
Last Update Date:2012-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ2000184261QR0405X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0100404 01Medicaid