Organization
MH AT CLARK LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES STOKES (CEO)
(561) 318-4455
Entity
Organization
Contact information
Practice address
60 WALNUT AVE STE 200, CLARK, NJ 07066-1647
(732) 882-1920
Mailing address
2328 10TH AVE N STE 302, LAKE WORTH, FL 33461-6612
(561) 318-4455
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
103TP2701X
Group Psychotherapy Psychologist
—
—
Other
Enumeration date
02/18/2015
Last updated
02/18/2015
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