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59 Koch Ave Morris Plains NJ 07950-4400 | |
| (973) 898-4940 | |
| (973) 889-8786 |
| Full Name | |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 59 Koch Ave, Morris Plains, New Jersey |
| Authorized Official Name and Position | Marcia L. Brands (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 9738984940 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
59 Koch Ave P.o. Box 155 Morris Plains NJ 07950-4400 Ph: (973) 898-4940 | 59 Koch Ave Morris Plains NJ 07950-4400 Ph: (973) 898-4940 |
| NPI Number | 1053478834 |
|---|---|
| Provider Enumeration Date | 01/02/2007 |
| Last Update Date | 09/29/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053478834 | NPI | - | NPPES |
| 300030104 | Other | NJ | FACILITY LICENSE - DHS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 300030104 (New Jersey) | Primary |
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