Organization
MIND BODY RECOVERY CENTER, LLC
Active
Organization
MIND BODY RECOVERY CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
REBECCA HENRIQUEZ LCSW (PRESIDENT)
(201) 543-3935
Entity
Organization
Contact information
Practice address
12 N STATE RT 17, SUITE 313, PARAMUS, NJ 07652-2644
(201) 543-3935
(201) 226-1141
Mailing address
12 N STATE RT 17, SUITE 313, PARAMUS, NJ 07652-2644
(201) 543-3935
(201) 226-1141
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
44SCO5258800
NJ
Other
Enumeration date
07/15/2011
Last updated
10/22/2015
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