Organization
EUCALYPTUSONE
Active
Other names
BL3ND TELE PSYCH
Organization subpart
No
Provider details
NPI number
Authorized official
MR. FERMIN CRUZ (ADMINISTRATOR)
(917) 224-7347
Entity
Organization
Contact information
Practice address
1 VERNON VIEW DR W, GLENWOOD, NJ 07418-1010
(917) 909-9449
Mailing address
PO BOX 92, GLENWOOD, NJ 07418-0092
(917) 909-9449
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Enumeration date
02/07/2023
Last updated
04/03/2026
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