Healthcare Provider Details

I. General information

NPI: 1689200800
Provider Name (Legal Business Name): HAVE FAITH BEHAVIORAL HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/19/2020
Last Update Date: 02/19/2021
Certification Date: 02/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2222 ROUTE 33 STE H
HAMILTON NJ
08690-1752
US

IV. Provider business mailing address

2222 ROUTE 33 STE H
HAMILTON NJ
08690-1752
US

V. Phone/Fax

Practice location:
  • Phone: 609-540-0316
  • Fax: 609-890-4189
Mailing address:
  • Phone: 609-540-0316
  • Fax: 609-890-4189

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 Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL ALEXANDER
Title or Position: CEO
Credential:
Phone: 609-540-0316