| Tidal Behavioral Aba Nj Llc | |
|
820 Bear Tavern Rd Ewing NJ 08628-1021 | |
| (718) 736-5689 | |
| Not Available |
| Full Name | Tidal Behavioral Aba Nj Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 820 Bear Tavern Rd, Ewing, New Jersey |
| Authorized Official Name and Position | Jack Elias (CONTROLLER) |
| Authorized Official Contact | 1718736568 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tidal Behavioral Aba Nj Llc 7 Sterling Pl Lawrence NY 11559-2414 Ph: (171) 873-6568 | Tidal Behavioral Aba Nj Llc 820 Bear Tavern Rd Ewing NJ 08628-1021 Ph: (718) 736-5689 |
| NPI Number | 1023872975 |
|---|---|
| Provider Enumeration Date | 02/12/2024 |
| Last Update Date | 02/12/2024 |
| Certification Date | 02/12/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023872975 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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