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1952 Us Highway 22 Bound Brook NJ 08805-1545 | |
| (908) 967-6214 | |
| (908) 967-6221 |
| Full Name | |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1952 Us Highway 22, Bound Brook, New Jersey |
| Authorized Official Name and Position | Dyshea Upshaw (OWNER/BCBA) |
| Authorized Official Contact | 8568316646 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
921 Grenville Dr Blackwood NJ 08012-1343 Ph: (856) 831-6646 | 1952 Us Highway 22 Bound Brook NJ 08805-1545 Ph: (908) 967-6214 |
| NPI Number | 1205645579 |
|---|---|
| Provider Enumeration Date | 01/02/2025 |
| Last Update Date | 01/02/2025 |
| Certification Date | 01/02/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205645579 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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