# CANAAN PSYCHIATRIC AND ADDICTION SERVICES LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1063175818
- **Authorized official:** MR. KEVIN OBI PSYCHIATRIC NP (AUTHORIZED OFFICIAL)
- **Authorized official phone:** (973) 342-5593

## Contact information

- **Practice address:** 4377 BRONX BLVD, BRONX, NY 10466-1397
- **Practice address phone:** (347) 912-7566
- **Practice address fax:** (646) 490-8780
- **Mailing address:** 1131 ELKER RD, UNION, NJ 07083-5006
- **Mailing address phone:** (347) 912-7566
- **Mailing address fax:** (646) 490-8780

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 10/19/2021
- **Last updated:** 10/19/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 5427909 | — | NY |