Provider Demographics
NPI:1730737016
Name:THE CENTER FOR INNER PEACE
Entity type:Organization
Organization Name:THE CENTER FOR INNER PEACE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GINA
Authorized Official - Middle Name:M
Authorized Official - Last Name:DIARCHANGEL
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:732-239-9268
Mailing Address - Street 1:157 BROAD ST STE 301
Mailing Address - Street 2:
Mailing Address - City:RED BANK
Mailing Address - State:NJ
Mailing Address - Zip Code:07701-2013
Mailing Address - Country:US
Mailing Address - Phone:732-239-9268
Mailing Address - Fax:
Practice Address - Street 1:157 BROAD ST STE 301
Practice Address - Street 2:
Practice Address - City:RED BANK
Practice Address - State:NJ
Practice Address - Zip Code:07701-2013
Practice Address - Country:US
Practice Address - Phone:732-239-9268
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-29
Last Update Date:2019-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty