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General NPI Number Information
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NPI Number | 1225273147
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Entity Type | Organization
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Legal Business Name | THE LESTER A. DRENK BEHAVIORAL HEALTH CENTER, INC.
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Dates
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Enumeration Date | 12/05/2008
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Last Update Date | 05/03/2012
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Provider Practice Location Address
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Address Line | 795 WOODLANE RD SUITE #301
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City | WESTAMPTON
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State | NJ
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Zip | 08060-3832
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Country | US
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Telephone | 609-267-1377
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Fax |
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Provider Business Mailing Address
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Address Line | 1289 ROUTE 38 SUITE #203
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City | HAINESPORT
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State | NJ
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Zip | 08036-2730
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Country | US
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Telephone | 609-267-5656
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MR. HARRY MARMORSTEIN
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Credential |
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Telephone | 609-267-5656
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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 | 402021604
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 402020604
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License Number State | NJ
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