Healthcare Provider Details

I. General information

NPI: 1962962175
Provider Name (Legal Business Name): TRUE CARE MENTAL HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/22/2019
Last Update Date: 02/22/2021
Certification Date: 02/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

570 N BROAD ST STE 3
ELIZABETH NJ
07208-4301
US

IV. Provider business mailing address

9 W BROADWAY FL 2
PATERSON NJ
07505-1014
US

V. Phone/Fax

Practice location:
  • Phone: 908-355-0050
  • Fax: 908-355-0018
Mailing address:
  • Phone: 973-977-2000
  • Fax: 973-977-2005

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: DAVID ADELAKUN
Title or Position: PROGRAM DIRECTOR
Credential:
Phone: 973-977-2000