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Organization

INTEGRAL DEVELOPMENT THERAPIES, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
VIRGINIA DOWNEY LCSW (OWNER)
(732) 241-3029
Entity
Organization

Contact information

Practice address
108 MAIN ST, SUITE #5, OCEANPORT, NJ 07757-1030
(732) 241-3029
(732) 865-7772
Mailing address
108 MAIN ST STE 5, OCEANPORT, NJ 07757-1030
(732) 241-3029
(732) 865-7772

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
44SC05358800
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1386780898
NPI INDIVIDUAL
NJ
Enumeration date
06/02/2011
Last updated
07/14/2011
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