Organization
MENTAL HEALTH THERAPEUTIC BEHAVIORAL SUPPORTS & DEV. DIS., LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARTHA TAYLOR MA (CEO)
(073) 762-2020
Entity
Organization
Contact information
Practice address
81 NORTHFIELD AVE STE 106, WEST ORANGE, NJ 07052-5343
(973) 762-2020
(973) 762-2021
Mailing address
60 N WYOMING AVE STE 106, SOUTH ORANGE, NJ 07079-1526
(973) 762-2020
(973) 762-2021
Taxonomy
Speciality
Code
Description
License number
State
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
11/05/2024
Last updated
11/05/2024
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