| Portum Behavioral Health | |
|
1465 Route 31 S Ste 1101 Annandale NJ 08801-3129 | |
| (551) 306-4000 | |
| Not Available |
| Full Name | Portum Behavioral Health |
|---|---|
| Speciality | Clinic/center - Adolescent And Children Mental Health |
| Location | 1465 Route 31 S Ste 1101, Annandale, New Jersey |
| Authorized Official Name and Position | Jeffrey Allen Decker (CHIEF OPERATING OFFICER) |
| Authorized Official Contact | 7326140994 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Portum Behavioral Health 1465 Route 31 S Ste 1101 Annandale NJ 08801-3129 Ph: (551) 306-4000 | Portum Behavioral Health 1465 Route 31 S Ste 1101 Annandale NJ 08801-3129 Ph: (551) 306-4000 |
| NPI Number | 1336975259 |
|---|---|
| Provider Enumeration Date | 09/09/2024 |
| Last Update Date | 09/09/2024 |
| Certification Date | 09/09/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336975259 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | (* (Not Available)) | Primary |
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