| Icms/housing. | |
|
725 Airport Rd Lakewood NJ 08701-5968 | |
| (732) 367-4700 | |
| Not Available |
| Full Name | Icms/housing. |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 725 Airport Rd, Lakewood, New Jersey |
| Authorized Official Name and Position | Julie Vanore (CA)) |
| Authorized Official Contact | 7324581700 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Icms/housing. P.o.box 2036 Preferred Behavioral Health Of New Jersey Lakewood NJ 08701 Ph: (732) 458-1700 | Icms/housing. 725 Airport Rd Lakewood NJ 08701-5968 Ph: (732) 367-4700 |
| NPI Number | 1457418717 |
|---|---|
| Provider Enumeration Date | 01/03/2007 |
| Last Update Date | 03/06/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457418717 | NPI | - | NPPES |
| 4549601 | Medicaid | NJ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 203020348 (New Jersey) | Primary |
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