# BONNIE BRAE

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

## Provider details

- **NPI number:** 1508220922
- **Authorized official:** MR. WILLIAM M. POWERS MHA, MPA (CHIEF EXECUTIVE OFFICER)
- **Authorized official phone:** (908) 647-0800

## Contact information

- **Practice address:** 3415 VALLEY ROAD, LIBERTY CORNER, NJ 07938-0825
- **Practice address phone:** (908) 647-0800
- **Practice address fax:** (908) 647-5021
- **Mailing address:** PO BOX 825, LIBERTY CORNER, NJ 07938-0825
- **Mailing address phone:** (908) 647-0800
- **Mailing address fax:** (908) 647-5021

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 322D00000X | Emotionally Disturbed Childrens' Residential Treatment Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 04/12/2016
- **Last updated:** 04/12/2016