| Kwenyan Professional Health Services, Llc | |
|
291 Pickford Ave Phillipsburg NJ 08865-1626 | |
| (908) 777-3744 | |
| (908) 777-3746 |
| Full Name | Kwenyan Professional Health Services, Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 291 Pickford Ave, Phillipsburg, New Jersey |
| Authorized Official Name and Position | Dr. Daniel Estrada Cassell, Ph.d., Mph (PRESIDENT/CEO: ADMINISTRATOR) |
| Authorized Official Contact | 2154323702 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kwenyan Professional Health Services, Llc 291 Pickford Ave Phillipsburg NJ 08865-1626 Ph: (908) 777-3744 | Kwenyan Professional Health Services, Llc 291 Pickford Ave Phillipsburg NJ 08865-1626 Ph: (908) 777-3744 |
| NPI Number | 1003392374 |
|---|---|
| Provider Enumeration Date | 07/19/2018 |
| Last Update Date | 07/19/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003392374 | NPI | - | NPPES |
| 101950304 | Other | NJ | INTENSIVE OUTPATIENT MENTAL HEALTH SERVICES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | 101950304 (New Jersey) | Primary |
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