Organization
BONNIE BRAE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WILLIAM M. POWERS MHA, MPA (CHIEF EXECUTIVE OFFICER)
(908) 647-0800
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
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
—
—
Other
Enumeration date
04/12/2016
Last updated
04/12/2016
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