Organization
GROWTH OUTPATIENT MENTAL HEALTH SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAMIRAH BOSTIC (OWNER/ PSYCHIATRIC PROVIDER)
(732) 844-3424
Entity
Organization
Contact information
Practice address
485C US HIGHWAY 1 S STE 100-36, ISELIN, NJ 08830-3037
(732) 844-3424
Mailing address
PO BOX 392, AVENEL, NJ 07001-0392
(732) 844-3424
(732) 621-8342
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
09/11/2023
Last updated
06/10/2025
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