Organization
BONNIE BRAE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PAUL D. RIEGER MSW (CHIEF EXECUTIVE OFFICER)
(908) 647-4719
Entity
Organization
Contact information
Practice address
3415 VALLEY ROAD, LIBERTY CORNER, NJ 07938-0825
(908) 647-0800
(908) 647-5021
Mailing address
PO BOX 825, LIBERTY CORNER, NJ 07938-0825
(908) 647-0800
(908) 647-5021
Taxonomy
Speciality
Code
Description
License number
State
323P00000X
Psychiatric Residential Treatment Facility
Primary
—
—
Other
Enumeration date
03/09/2020
Last updated
03/09/2020
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