Organization
MENTAL HEALTH ASSOCIATION OF ESSEX AND MORRIS
Active
Parent organization
MENTAL HEALTH ASSOCIATION OF ESSEX AND MORRIS
Other names
prospect house
Organization subpart
Yes
Provider details
NPI number
Legal business name
MENTAL HEALTH ASSOCIATION OF ESSEX AND MORRIS
Authorized official
MS. OLUFUNMILAYO O ILORI APRN, PMHNP-BC (ADVANCED PRACTICE NURSE)
(973) 674-8067
Entity
Organization
Contact information
Practice address
33 S FULLERTON AVE, MONTCLAIR, NJ 07042
(973) 674-8067
(973) 677-7719
Mailing address
424, MAIN STREET, EAST ORANGE, NJ 07018
(973) 674-8067
(973) 677-7719
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
26NJ00355200
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
26NJ00355200
ADVANCED PRACTICE WITH PRESCRIPTIVE AUTHORITY
NJ
01
—
P00440300
CDS REGISTRATION NUMBER
NJ
Enumeration date
02/08/2012
Last updated
03/07/2023
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