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General NPI Number Information
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NPI Number | 1043226806
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Entity Type | Organization
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Legal Business Name | V.A.N.J.HEALTHCARE SYSTEM
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Dates
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Enumeration Date | 08/01/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 151 KNOLLCROFT RD BLDG. 57
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City | LYONS
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State | NJ
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Zip | 07939-5001
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Country | US
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Telephone | 908-647-0180
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Fax | 908-604-5850
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Provider Business Mailing Address
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Address Line | 4533 LANDISVILLE RD
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City | DOYLESTOWN
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State | PA
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Zip | 18901-1246
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Country | US
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Telephone | 215-348-1886
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Fax |
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Authorized Official
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Title or Position | SOCIAL WORKER
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Name | MR. RICHARD WILLARD LISBON
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Credential | M.S.W.,L.C.S.W.
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Telephone | 908-647-0180
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 283Q00000X
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Taxonomy Name | Psychiatric Hospital
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License Number | SW005596E
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License Number State | PA
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