Organization
PHOENIX FAMILY SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RAVI KADIR MAHARAJH LPC (PROGRAM DIRECTOR)
(732) 404-7604
Entity
Organization
Contact information
Practice address
210 RICHARDS AVE, PISCATAWAY, NJ 08854-2936
(732) 404-7064
(732) 424-6587
Mailing address
210 RICHARDS AVE, PISCATAWAY, NJ 08854-2936
(732) 404-7064
(732) 424-6587
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
NJ37PC00336800
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0162027
—
NJ
Enumeration date
06/21/2008
Last updated
06/21/2008
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