Organization
KWENYAN PROFESSIONAL HEALTH SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DANIEL E CASSELL MA, MPH, LPC, LCADC (PRESIDENT/CEO)
(973) 672-6900
Entity
Organization
Contact information
Practice address
60 EVERGREEN PL, SUITE 500, EAST ORANGE, NJ 07018-2106
(973) 672-6900
(866) 376-8262
Mailing address
60 EVERGREEN PL, SUITE 500, EAST ORANGE, NJ 07018-2106
(973) 672-6900
(866) 376-8262
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
0261351
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0261351
—
NJ
Enumeration date
06/06/2011
Last updated
06/06/2011
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