Organization
GARDEN STATE PSYCHIATRIC SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DIANE WRIGHT (APN)
(856) 628-4504
Entity
Organization
Contact information
Practice address
58 EUCLID ST, WOODBURY, NJ 08096-4626
(856) 628-4504
Mailing address
58 EUCLID ST, WOODBURY, NJ 08096-4626
(856) 628-4504
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
05
—
00000000
—
NJ
Enumeration date
05/27/2019
Last updated
10/03/2019
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