MEDICARE: SPRINGVALLEY BEHAVIORAL & DD SERVICES LLC

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

General Provider Information

NPI Number	:	1982557401
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SPRINGVALLEY BEHAVIORAL & DD SERVICES LLC

Provider Business Mailing Address
First Line	:	1000C STUYVESANT AVE
Second Line	:
City	:	UNION
State	:	NJ
Zip	:	07083-6992
Country	:	US
Telephone Number	:	614-966-7792
Fax Number	:	908-258-8908

Provider Business Practice Location Address
First Line	:	1000C STUYVESANT AVE
Second Line	:
City	:	UNION
State	:	NJ
Zip	:	07083-6992
Country	:	US
Telephone Number	:	614-966-7792
Fax Number	:	908-258-8908

Authorized Official
Title or Position	:	OWNER
Name	:	GERALD YEBOAH YEBOAH
Credential	:
Telephone Number	:	614-966-7792

Provider Enumeration Date	:	02/16/2026
Last Update Date	:	02/16/2026

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