MEDICARE: ORIAH BEHAVIORAL HEALTH INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency	25MA08022900	NJ

General Provider Information

NPI Number	:	1548611874
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ORIAH BEHAVIORAL HEALTH INC.

Provider Business Mailing Address
First Line	:	1215 HIGHWAY 70 STE 1001B
Second Line	:
City	:	LAKEWOOD
State	:	NJ
Zip	:	08701-6958
Country	:	US
Telephone Number	:	732-942-5057
Fax Number	:	732-942-5058

Provider Business Practice Location Address
First Line	:	1215 HIGHWAY 70 STE 1001B
Second Line	:
City	:	LAKEWOOD
State	:	NJ
Zip	:	08701-6958
Country	:	US
Telephone Number	:	732-942-5057
Fax Number	:	732-942-5058

Authorized Official
Title or Position	:	OWNER
Name	:	DR. TONY JUNEJA
Credential	:	M.D.
Telephone Number	:	732-942-5057

Provider Enumeration Date	:	06/28/2016
Last Update Date	:	06/28/2016

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