Healthcare Provider Details

I. General information

NPI: 1851966956
Provider Name (Legal Business Name): ANCHOR BEHAVIORAL SOLUTIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/21/2021
Last Update Date: 05/21/2021
Certification Date: 05/21/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

463 VALLEY ST
MAPLEWOOD NJ
07040-1330
US

IV. Provider business mailing address

PO BOX 3111
WEST ORANGE NJ
07052-3061
US

V. Phone/Fax

Practice location:
  • Phone: 862-343-6429
  • Fax:
Mailing address:
  • Phone: 862-233-7552
  • Fax: 844-383-2420

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: ASLAM ALI
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 201-618-9529