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Organization

GRACE BEHAVIORAL HEALTH SERVICES

Active
Organization subpart
No

Provider details

NPI number
Authorized official
OMEZIE MOLOKWU APN (PRESIDENT)
(908) 417-0632
Entity
Organization

Contact information

Practice address
1140 BURNT TAVERN RD STE 1A, BRICK, NJ 08724-1496
(908) 417-0632
Mailing address
PO BOX 46, LAKEHURST, NJ 08733-0046
(908) 417-0632

Taxonomy

Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
261QM0855X
Adolescent and Children Mental Health Clinic/Center
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary

Other

Enumeration date
09/24/2020
Last updated
08/29/2023
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