Organization
PAPOOSE BEHAVIORAL HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BOLANLE OLUGBILE CEO (CEO)
(718) 775-8507
Entity
Organization
Contact information
Practice address
105 DANIEL AVE UNIT 2, RUTHERFORD, NJ 07070-2718
(718) 775-8507
Mailing address
105 DANIEL AVE UNIT 2, RUTHERFORD, NJ 07070-2718
(718) 775-8507
Taxonomy
Speciality
Code
Description
License number
State
103TM1800X
Intellectual & Developmental Disabilities Psychologist
—
—
251S00000X
Community/Behavioral Health Agency
—
—
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
—
Other
Enumeration date
04/14/2023
Last updated
04/14/2023
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