| Prodigal Sons And Daughters Behavioral Healthcare Services | |
|
60 Evergreen Pl Ste 904 East Orange NJ 07018-2114 | |
| (973) 678-3966 | |
| (973) 678-3968 |
| Full Name | Prodigal Sons And Daughters Behavioral Healthcare Services |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 60 Evergreen Pl Ste 904, East Orange, New Jersey |
| Authorized Official Name and Position | Henry Duane Muhammad-hamilton (FOUNDER/CEO) |
| Authorized Official Contact | 9736783966 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Prodigal Sons And Daughters Behavioral Healthcare Services Po Box 28109 Newark NJ 07101-2486 Ph: (973) 703-3262 | Prodigal Sons And Daughters Behavioral Healthcare Services 60 Evergreen Pl Ste 904 East Orange NJ 07018-2114 Ph: (973) 678-3966 |
| NPI Number | 1760901623 |
|---|---|
| Provider Enumeration Date | 09/12/2017 |
| Last Update Date | 06/16/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760901623 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 100230104 (New Jersey) | Primary |
| 324500000X | Substance Abuse Rehabilitation Facility | 2000609 (New Jersey) | Secondary |
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