Healthcare Provider Details

I. General information

NPI: 1316851827
Provider Name (Legal Business Name): GOD BROTHERS BEHAVIORAL SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/01/2026
Last Update Date: 10/01/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

234B SHERIDAN ST
PERTH AMBOY NJ
08861-4521
US

IV. Provider business mailing address

234B SHERIDAN ST
PERTH AMBOY NJ
08861-4521
US

V. Phone/Fax

Practice location:
  • Phone: 732-646-5499
  • Fax:
Mailing address:
  • Phone: 732-646-5499
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateNULL

VIII. Authorized Official

Name: TISHA SIMMS
Title or Position: CEO
Credential:
Phone: 732-890-1954