Organization
NEW BEHAVIORAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOSEPH BOETTCHER (COO)
(856) 669-0217
Entity
Organization
Contact information
Practice address
2 PIN OAK LN, UNIT 250, CHERRY HILL, NJ 08003-1632
(856) 874-1616
(856) 424-7660
Mailing address
2 PIN OAK LN, UNIT 250, CHERRY HILL, NJ 08003-1632
(856) 874-1616
(856) 424-7660
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0065153
—
NJ
01
—
64681028
PERFORM CARE
NJ
Enumeration date
01/12/2010
Last updated
01/12/2010
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