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700 Airport Rd Lakewood NJ 08701-5907 | |
| (732) 367-4700 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 700 Airport Rd, Lakewood, New Jersey |
| Authorized Official Name and Position | Julie Vanore (CAO) |
| Authorized Official Contact | 7324581700 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 2036 Lakewood NJ 08701-8036 Ph: (732) 367-4700 | 700 Airport Rd Lakewood NJ 08701-5907 Ph: (732) 367-4700 |
| NPI Number | 1922472190 |
|---|---|
| Provider Enumeration Date | 11/25/2015 |
| Last Update Date | 03/06/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922472190 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 2000152 (New Jersey) | Primary |
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