Organization
TRI-STATE BEHAVIORAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VINCENT TROY SANTOS (CEO)
(201) 572-4893
Entity
Organization
Contact information
Practice address
77 CENTER GROVE RD, RANDOLPH, NJ 07869-4411
(201) 572-4893
Mailing address
77 CENTER GROVE RD, RANDOLPH, NJ 07869-4411
(201) 572-4893
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
106S00000X
Behavior Technician
—
—
251S00000X
Community/Behavioral Health Agency
—
—
252Y00000X
Early Intervention Provider Agency
—
—
253Z00000X
In Home Supportive Care Agency
—
—
261QD1600X
Developmental Disabilities Clinic/Center
—
—
261QH0700X
Hearing and Speech Clinic/Center
—
—
315P00000X
Intellectual Disabilities Intermediate Care Facility
—
—
Other
Enumeration date
12/06/2022
Last updated
12/06/2022
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