Organization
WELLESLEY HEALTHCARE GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARLON WELLESLEY GRAY (PRESIDENT)
(201) 726-2265
Entity
Organization
Contact information
Practice address
16 W MAIN ST, FL 2, FREEHOLD, NJ 07728-2210
(732) 333-0197
(732) 333-0198
Mailing address
529 BUTTONWOOD DR, JACKSON, NJ 08527-4945
(732) 333-0197
(732) 333-0198
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
—
—
Other
Enumeration date
10/10/2009
Last updated
10/10/2009
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