Organization
PREFERRED BEHAVIORAL HEALTH OF NJ
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JULIE VANORE (CAO)
(732) 458-1700
Entity
Organization
Contact information
Practice address
725 AIRPORT RD, LAKEWOOD, NJ 08701-5968
(732) 367-8859
(732) 367-8859
Mailing address
PO BOX 2036, IOTSS PROGRAM, LAKEWOOD, NJ 08701-8036
(732) 367-8859
(732) 364-8242
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
20302-17-04
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5255902
—
NJ
01
—
526788
GROUP MEDICARE NUMBER
NJ
Enumeration date
05/05/2009
Last updated
03/06/2019
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