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General NPI Number Information
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NPI Number | 1386596286
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Entity Type | Organization
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Legal Business Name | LUMAMIND BEHAVIORAL CENTER LLC
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Dates
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Enumeration Date | 02/12/2026
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Last Update Date | 02/12/2026
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Provider Practice Location Address
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Address Line | 411 STATE ROUTE 17 SUITE 500
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City | HASBROUCK HEIGHTS
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State | NJ
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Zip | 07604
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Country | US
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Telephone | 646-201-6645
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Fax | 646-201-6645
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Provider Business Mailing Address
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Address Line | 186 PATERSON AVE STE 201
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City | EAST RUTHERFORD
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State | NJ
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Zip | 07073-1837
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Country | US
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Telephone | 646-201-6645
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Fax | 646-201-6645
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Authorized Official
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Title or Position | CEO
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Name | GBEMISOLA ORE-OFE
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Credential | PMHNP
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Telephone | 646-201-6645
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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