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Northeast Life Skills Associates, Inc.

Methadone Clinic in Passaic, NJ · enumerated 2005 · authorized official Carolyn Illge, Executive Director.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1093707192

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Registry record

Entity type Organization (Type 2)
Legal business name Northeast Life Skills Associates, Inc.
Other name <Unavail>
Practice address 121 Howe Ave, Passaic, NJ, 07055
Phone (973) 777-2962
Fax (973) 777-7623
Enumeration date Aug 16, 2005
Last updated in NPPES Aug 22, 2020

Taxonomy & classification

261QM2800X Methadone Clinic Ambulatory Health Care Facilities · License 22306 (NJ) Primary
261QM2800X Methadone Clinic Ambulatory Health Care Facilities · License 10CC00058000 (NJ) Secondary

Authorized official

Name Carolyn Illge
Title Executive Director
Phone (973) 777-2962

Other identifiers

Identifier Type State Issuer
7633203 Medicaid NJ -
0101401 Medicaid NJ -

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

What is the NPI number for Northeast Life Skills Associates, Inc.?
The NPI for Northeast Life Skills Associates, Inc. is 1093707192, a Type 2 (organization) record in the CMS NPPES registry.
Who is the authorized official for Northeast Life Skills Associates, Inc.?
NPPES lists Carolyn Illge (Executive Director) as the authorized official for this organization.

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2020-08-22.