| Psychiatric And Behavioral Health Care Llc | |
|
555 High St Mount Holly NJ 08060-1045 | |
| (732) 986-1971 | |
| Not Available |
| Full Name | Psychiatric And Behavioral Health Care Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 555 High St, Mount Holly, New Jersey |
| Authorized Official Name and Position | Adeoluwa Adeyemo (PRESIDENT) |
| Authorized Official Contact | 7329861971 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Psychiatric And Behavioral Health Care Llc Po Box 1223 Burlington NJ 08016-0823 Ph: (732) 986-1971 | Psychiatric And Behavioral Health Care Llc 555 High St Mount Holly NJ 08060-1045 Ph: (732) 986-1971 |
| NPI Number | 1487222709 |
|---|---|
| Provider Enumeration Date | 06/14/2021 |
| Last Update Date | 03/26/2023 |
| Certification Date | 03/26/2023 |
| Medicare PECOS PAC ID | 1658776281 |
|---|---|
| Medicare Enrollment ID | O20210820000011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487222709 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Adeoluwa Modupe Adeyemo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285209536 PECOS PAC ID: 5395044580 Enrollment ID: I20210820000026 |
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