Organization
EPIPHANY HOUSE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICIA RUTH LABUNSKI (EXECUTIVE DIRECTOR)
(732) 775-0720
Entity
Organization
Contact information
Practice address
373 BRIGHTON AVE, LONG BRANCH, NJ 07740-5201
(732) 870-9113
(732) 870-3372
Mailing address
1110 GRAND AVE, ASBURY PARK, NJ 07712-6012
(732) 775-0720
(732) 502-0065
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7605404
—
NJ
Enumeration date
12/26/2006
Last updated
08/22/2020
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