# PAPOOSE BEHAVIORAL HEALTH

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

## Provider details

- **NPI number:** 1104512839
- **Authorized official:** BOLANLE OLUGBILE CEO (CEO)
- **Authorized official phone:** (718) 775-8507

## Contact information

- **Practice address:** 105 DANIEL AVE UNIT 2, RUTHERFORD, NJ 07070-2718
- **Practice address phone:** (718) 775-8507
- **Mailing address:** 105 DANIEL AVE UNIT 2, RUTHERFORD, NJ 07070-2718
- **Mailing address phone:** (718) 775-8507

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 103TM1800X | Intellectual & Developmental Disabilities Psychologist | — | NULL | — |
| 103TM1800X | Intellectual & Developmental Disabilities Psychologist | — | — | — |
| 251S00000X | Community/Behavioral Health Agency | — | NULL | — |
| 320600000X | Intellectual and/or Developmental Disabilities Residential Treatment Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 04/14/2023
- **Last updated:** 04/14/2023