Healthcare Provider Details

I. General information

NPI: 1699606764
Provider Name (Legal Business Name): MARK BEHAVIORAL OF NJ LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/27/2026
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 KINGS HWY S
CHERRY HILL NJ
08034-2500
US

IV. Provider business mailing address

6574 N STATE ROAD 7 # 154
COCONUT CREEK FL
33073-3625
US

V. Phone/Fax

Practice location:
  • Phone: 856-475-6166
  • Fax:
Mailing address:
  • Phone: 954-675-6898
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL BORKOWSKI
Title or Position: MANAGER
Credential:
Phone: 954-675-6898