Healthcare Provider Details
I. General information
NPI: 1447199351
Provider Name (Legal Business Name): PIONEER BEHAVIORAL HEALTH NETWORK BRIDGEWATER
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/26/2026
Last Update Date: 03/26/2026
Certification Date: 03/26/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
380 FOOTHILL ROAD
BRIDGEWATER NJ
08807
US
IV. Provider business mailing address
380 FOOTHILL ROAD
BRIDGEWATER NJ
08807
US
V. Phone/Fax
- Phone: 855-283-0050
- Fax:
- Phone: 855-283-0050
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2084P0800X |
| Taxonomy | Psychiatry Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QM0801X |
| Taxonomy | Mental Health Clinic/Center (Including Community Mental Health Center) |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
HENRY
ODUNLAMI
Title or Position: CEO
Credential: MD
Phone: 908-800-9696