Healthcare Provider Details

I. General information

NPI: 1962170761
Provider Name (Legal Business Name): CENTER BEHAVIORAL HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/06/2021
Last Update Date: 09/06/2021
Certification Date: 09/06/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

121 S WHITE HORSE PIKE
HAMMONTON NJ
08037-1871
US

IV. Provider business mailing address

501 PROSPECT STREET BUILDING 1A, SUITE 8
LAKEWOOD NJ
08701
US

V. Phone/Fax

Practice location:
  • Phone: 609-704-1313
  • Fax: 609-704-1208
Mailing address:
  • Phone: 848-525-9877
  • Fax: 732-961-1125

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. ELIYAHU DANZIGER
Title or Position: CEO
Credential:
Phone: 848-525-9877