1396178430 NPI number — TRUE CARE MENTAL HEALTH CLINIC LLC

NPI Number: 1396178430
Health Care Provider/Practitioner: TRUE CARE MENTAL HEALTH CLINIC LLC

NPI Number : 1396178430 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1396178430",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "TRUE CARE MENTAL HEALTH CLINIC LLC",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "675 BROADWAY",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "PATERSON",
    "MailingAddressStateName": "NJ",
    "MailingAddressPostalCode": "07514-1444",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "973-977-2000",
    "MailingAddressFaxNumber": "973-977-2005",
    "FirstLinePracticeLocationAddress": "675 BROADWAY",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "PATERSON",
    "PracticeLocationAddressStateName": "NJ",
    "PracticeLocationAddressPostalCode": "07514-1444",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "888-500-9661",
    "PracticeLocationAddressFaxNumber": "973-977-2001",
    "EnumerationDate": "08/13/2013",
    "LastUpdateDate": "10/10/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": "01/23/2019",
    "NPIReactivationDate": "08/07/2019",
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "ADELAKUN",
    "AuthorizedOfficialFirstName": "DAVID",
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": "PROGRAM DIRECTOR",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": "973-977-2000",
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "261Q00000X",
          "TaxonomyName": "Clinic/Center",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "261QM0801X",
          "TaxonomyName": "Mental Health Clinic/Center (Including Community Mental Health Center)",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}