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Organization

PA MENTAL HEALTH

Active
Other names
PA Mental Health
Organization subpart
No

Provider details

NPI number
Authorized official
MR. MIGUEL A MATOS LPC (LICENSED MENTAL HEALTH COUN CEO)
(908) 759-2376
Entity
Organization

Contact information

Practice address
204 ERIE ST STE 2FL, ELIZABETH, NJ 07206-1569
(908) 759-2370
(908) 469-5817
Mailing address
204 ERIE ST STE 2FL, ELIZABETH, NJ 07206-1569
(908) 759-2370
(908) 469-5817

Taxonomy

Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1033399555
NPI
PA
Enumeration date
12/28/2018
Last updated
12/28/2018
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