| Park Place | |
|
1011 Bond St Asbury Park NJ 07712-5939 | |
| (732) 869-2769 | |
| (732) 897-9541 |
| Full Name | Park Place |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 1011 Bond St, Asbury Park, New Jersey |
| Authorized Official Name and Position | Susan M Affa (SOCIAL WORKER/INTAKE COORDINATOR) |
| Authorized Official Contact | 7328692769 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Park Place 1011 Bond St Asbury Park NJ 07712-5939 Ph: (732) 869-2769 | Park Place 1011 Bond St Asbury Park NJ 07712-5939 Ph: (732) 869-2769 |
| NPI Number | 1770836025 |
|---|---|
| Provider Enumeration Date | 10/24/2012 |
| Last Update Date | 10/24/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770836025 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | 44SL05734800 (New Jersey) | Primary |
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