| The Fulton Center For Valued Living, Llc | |
|
445 Brick Blvd Ste 302 Brick NJ 08723-6080 | |
| (908) 415-6354 | |
| Not Available |
| Full Name | The Fulton Center For Valued Living, Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 445 Brick Blvd Ste 302, Brick, New Jersey |
| Authorized Official Name and Position | Justine Fulton (CLINICAL PSYCHOLOGIST) |
| Authorized Official Contact | 7323309440 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| The Fulton Center For Valued Living, Llc 445 Brick Blvd Ste 302 Brick NJ 08723-6080 Ph: (908) 415-6354 | The Fulton Center For Valued Living, Llc 445 Brick Blvd Ste 302 Brick NJ 08723-6080 Ph: (908) 415-6354 |
| NPI Number | 1114560893 |
|---|---|
| Provider Enumeration Date | 10/24/2019 |
| Last Update Date | 10/24/2019 |
| Medicare PECOS PAC ID | 6406281203 |
|---|---|
| Medicare Enrollment ID | O20200125000025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114560893 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Justine Victoria Fulton |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1225679426 PECOS PAC ID: 7214362011 Enrollment ID: I20200212002503 |
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