Healthcare Provider Details

I. General information

NPI: 1871938514
Provider Name (Legal Business Name): THE LESTER A. DRENK BEHAVIORAL HEALTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/08/2013
Last Update Date: 05/08/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1289 ROUTE 38 SUITE 203
HAINESPORT NJ
08036-2730
US

IV. Provider business mailing address

1289 ROUTE 38 SUITE 203
HAINESPORT NJ
08036-2730
US

V. Phone/Fax

Practice location:
  • Phone: 609-267-5656
  • Fax: 609-265-1895
Mailing address:
  • Phone: 609-267-5656
  • Fax: 609-265-1895

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNJ

VIII. Authorized Official

Name: MRS. BETTY H GARRISON
Title or Position: CHIEF FINANCIAL OFFICER
Credential: BBA
Phone: 609-267-5656