| Kwenyan Professional Health Services, Llc | |
|
860 Lower Ferry Rd Suite 1 Ewing NJ 08628-3525 | |
| (609) 403-8740 | |
| (609) 403-8740 |
| Full Name | Kwenyan Professional Health Services, Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 860 Lower Ferry Rd, Ewing, New Jersey |
| Authorized Official Name and Position | Daniel E Cassell (PRESIDENT/CEO) |
| Authorized Official Contact | 6094038740 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kwenyan Professional Health Services, Llc 860 Lower Ferry Rd Suite 1 Ewing NJ 08628-3525 Ph: (609) 403-8740 | Kwenyan Professional Health Services, Llc 860 Lower Ferry Rd Suite 1 Ewing NJ 08628-3525 Ph: (609) 403-8740 |
| NPI Number | 1598196719 |
|---|---|
| Provider Enumeration Date | 12/13/2013 |
| Last Update Date | 12/13/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598196719 | NPI | - | NPPES |
| 1111 | Medicaid | NJ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | 100800104 (New Jersey) | Primary |
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