Organization
BAINBRIDGE HOUSE, LLC
Active
Other names
Bainbridge House COunseling Services
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARA OLIVA MA, LPC, LMHC (DIRECTOR)
(201) 919-6184
Entity
Organization
Contact information
Practice address
200 PASSAIC ST, HACKENSACK, NJ 07601-3525
(551) 800-7101
Mailing address
200 PASSAIC ST, HACKENSACK, NJ 07601-3525
(551) 800-7101
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
37PC00526200
NJ
Other
Enumeration date
09/11/2015
Last updated
09/11/2015
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