Healthcare Provider Details

I. General information

NPI: 1952854887
Provider Name (Legal Business Name): GARDEN PSYCHIATRIC SYSTEMS ASSOCIATES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/27/2016
Last Update Date: 07/27/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16 WHITESVILLE RD
TOMS RIVER NJ
08753-4107
US

IV. Provider business mailing address

16 WHITESVILLE RD
TOMS RIVER NJ
08753-4107
US

V. Phone/Fax

Practice location:
  • Phone: 732-797-2505
  • Fax:
Mailing address:
  • Phone: 732-797-2505
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: JAMES AITKEN
Title or Position: CEO
Credential:
Phone: 561-318-4455