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Organization

MONMOUTH HEALTHCARE SERVICES, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
CHRISTOPHER BASS (OWNER)
(856) 558-3250
Entity
Organization

Contact information

Practice address
495 JACK MARTIN BLVD, BRICK, NJ 08724-7778
(732) 344-0596
Mailing address
495 JACK MARTIN BLVD, BRICK, NJ 08724-7778
(732) 344-0596

Taxonomy

Speciality
Code
Description
License number
State
261QM2800X
Methadone Clinic
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0744611
NJ
Enumeration date
01/06/2021
Last updated
01/06/2021
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