Organization
BONNIE BRAE
Active
Parent organization
BONNIE BRAE
Organization subpart
Yes
Provider details
NPI number
Legal business name
BONNIE BRAE
Authorized official
MR. WILLIAM M. POWERS (CFO)
(908) 647-0800
Entity
Organization
Contact information
Practice address
3415 VALLEY RD, BASKING RIDGE, NJ 07920-2655
(908) 647-0800
(908) 647-5021
Mailing address
3415 VALLEY ROAD, PO BOX 825, LIBERTY CORNER, NJ 07938-0825
(908) 647-0800
(908) 647-5021
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
—
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0073661
—
NJ
Enumeration date
04/24/2008
Last updated
04/24/2008
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