Healthcare Provider Details

I. General information

NPI: 1346927761
Provider Name (Legal Business Name): PREVENTIVE MEASURES OF NEW JERSEY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/28/2023
Last Update Date: 09/05/2023
Certification Date: 09/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

185 6TH AVE
PATERSON NJ
07524-1241
US

IV. Provider business mailing address

515 W LINDEN ST
ALLENTOWN PA
18101-1426
US

V. Phone/Fax

Practice location:
  • Phone: 484-225-4323
  • Fax:
Mailing address:
  • Phone: 484-226-0986
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: ERIN HARRIS
Title or Position: PRESIDENT/CFO
Credential:
Phone: 484-226-0986