Healthcare Provider Details

I. General information

NPI: 1891617783
Provider Name (Legal Business Name): OAKLAND BEHAVIORAL HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/29/2026
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1473 COOLIDGE ST
PLAINFIELD NJ
07062-2123
US

IV. Provider business mailing address

1473 COOLIDGE ST
PLAINFIELD NJ
07062-2123
US

V. Phone/Fax

Practice location:
  • Phone: 617-905-8743
  • Fax: 617-905-8743
Mailing address:
  • Phone: 617-905-8743
  • Fax: 617-905-8743

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: NADEGE DHAITI
Title or Position: OWNER
Credential: LAC
Phone: 617-905-8743