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General NPI Number Information
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NPI Number | 1043853328
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Entity Type | Organization
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Legal Business Name | JERSEY BEHAVIORAL CARE LLC
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Dates
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Enumeration Date | 10/19/2019
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Last Update Date | 03/26/2020
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Provider Practice Location Address
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Address Line | 220 DAVIDSON AVE STE 306
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City | SOMERSET
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State | NJ
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Zip | 08873-4144
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Country | US
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Telephone | 917-701-9588
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Fax |
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Provider Business Mailing Address
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Address Line | 9 HUXLEY CT
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City | MARLBORO
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State | NJ
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Zip | 07746-2140
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Country | US
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Telephone | 732-685-7277
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. FELIX GRINBERG
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Credential |
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Telephone | 732-685-7277
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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