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General NPI Number Information
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NPI Number | 1265356083
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Entity Type | Organization
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Legal Business Name | RED OAK WELLNESS
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Dates
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Enumeration Date | 08/05/2026
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Last Update Date | 08/05/2026
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Provider Practice Location Address
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Address Line | 28 W GRAND AVE STE 4
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City | MONTVALE
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State | NJ
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Zip | 07645-2100
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Country | US
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Telephone | 772-812-9652
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Fax | 833-535-0164
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Provider Business Mailing Address
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Address Line | 58 N NEW ARDMORE AVE
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City | BROOMALL
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State | PA
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Zip | 19008-2608
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Country | US
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Telephone | 772-812-9652
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Fax | 833-535-0164
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Authorized Official
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Title or Position | BILLING MANAGER
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Name | JARED TURNER
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Credential |
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Telephone | 772-812-9652
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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