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General NPI Number Information
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NPI Number | 1346427531
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Entity Type | Organization
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Legal Business Name | SAINT CLARES BEHAVIORAL HEALTH
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Dates
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Enumeration Date | 01/30/2008
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Last Update Date | 01/30/2008
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Provider Practice Location Address
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Address Line | 70 SPARTA AVE
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City | SPARTA
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State | NJ
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Zip | 07871-1760
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Country | US
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Telephone | 973-729-3117
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Fax | 973-729-8113
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Provider Business Mailing Address
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Address Line | 130 POWERVILLE RD
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City | BOONTON
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State | NJ
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Zip | 07005-8705
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Country | US
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Telephone | 973-316-1800
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Fax |
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Authorized Official
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Title or Position | STAFF CLINICIAN
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Name | MS. KAREN ANN JOHANNING
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Credential | LPC
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Telephone | 973-729-3117
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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 | 37PC00280900
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License Number State | NJ
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