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Organization
LACKA BEHAVIORAL HEALTH LLC
Active
Organization
LACKA BEHAVIORAL HEALTH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LORETTA N OGUONU DNP (OWNER OF ENTITY)
(609) 577-9741
Entity
Organization
Contact information
Practice address
2911 LAKEWOOD RD, POINT PLEASANT BORO, NJ 08742-2871
(609) 577-9741
(609) 372-2483
Mailing address
PO BOX 422, BORDENTOWN, NJ 08505-0422
(609) 577-9741
(609) 372-2483
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
NULL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
04/22/2021
Last updated
04/22/2021
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