Organization
SHORE BEHAVIORAL HEALTHCARE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. INUA A. MOMODU M.D., M.P.H. (MEDICAL DIRECTOR)
(609) 377-8118
Entity
Organization
Contact information
Practice address
333 TILTON RD, SUITE 5, NORTHFIELD, NJ 08225-1253
(609) 377-8118
(609) 377-8120
Mailing address
333 TILTON RD, SUITE 5, NORTHFIELD, NJ 08225-1253
(609) 377-8118
(609) 377-8120
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
37PC00309400
NJ
1041C0700X
Clinical Social Worker
44SC05007700
NJ
2084P0800X
Psychiatry Physician
Primary
25MA07531400
NJ
Other
Enumeration date
12/30/2009
Last updated
12/30/2009
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