| Pa Mental Health Professional Srvcs Llc | |
|
410 Birch Ct New Brunswick NJ 08901-2693 | |
| (908) 759-2376 | |
| Not Available |
| Full Name | Pa Mental Health Professional Srvcs Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 410 Birch Ct, New Brunswick, New Jersey |
| Authorized Official Name and Position | Miguel Angel Matos (CEO) |
| Authorized Official Contact | 9087592376 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pa Mental Health Professional Srvcs Llc 410 Birch Ct New Brunswick NJ 08901-2693 Ph: (908) 759-2376 | Pa Mental Health Professional Srvcs Llc 410 Birch Ct New Brunswick NJ 08901-2693 Ph: (908) 759-2376 |
| NPI Number | 1588365399 |
|---|---|
| Provider Enumeration Date | 03/17/2023 |
| Last Update Date | 03/17/2023 |
| Certification Date | 03/17/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588365399 | NPI | - | NPPES |
| 1033399555 | Medicaid | PA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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