Healthcare Provider Details

I. General information

NPI: 1295607372
Provider Name (Legal Business Name): RUBICON MENTAL HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/19/2025
Last Update Date: 09/19/2025
Certification Date: 09/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40 STIRLING RD STE 212
WATCHUNG NJ
07069-5954
US

IV. Provider business mailing address

40 STIRLING RD STE 212
WATCHUNG NJ
07069-5954
US

V. Phone/Fax

Practice location:
  • Phone: 772-812-9652
  • Fax:
Mailing address:
  • Phone: 772-812-9652
  • Fax: 833-535-0164

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JARED TURNER
Title or Position: BILLING MANAGER
Credential:
Phone: 772-812-9652