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General NPI Number Information
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NPI Number | 1083425805
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Entity Type | Organization
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Legal Business Name | VA BEHAVIORAL CONSULTING LLC
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Dates
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Enumeration Date | 01/20/2025
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Last Update Date | 01/20/2025
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Provider Practice Location Address
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Address Line | 4 BRIGHTON RD STE 400
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City | CLIFTON
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State | NJ
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Zip | 07012-1646
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Country | US
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Telephone | 201-581-6622
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Fax | 757-530-8212
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Provider Business Mailing Address
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Address Line | 4 BRIGHTON RD STE 400
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City | CLIFTON
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State | NJ
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Zip | 07012-1646
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Country | US
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Telephone | 201-581-6622
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Fax | 757-530-8212
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Authorized Official
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Title or Position | CFO
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Name | YEHUDA GITTLESON
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Credential |
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Telephone | 201-581-6622
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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