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General NPI Number Information
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NPI Number | 1447810155
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Entity Type | Organization
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Legal Business Name | TRENTON HEALTHCARE, LLC (WORKFIRST ONLY)
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Dates
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Enumeration Date | 06/14/2019
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Last Update Date | 06/14/2019
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Provider Practice Location Address
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Address Line | 801 NEW YORK AVE
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City | TRENTON
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State | NJ
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Zip | 08638-3913
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Country | US
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Telephone | 609-393-8000
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Fax | 609-393-8020
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Provider Business Mailing Address
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Address Line | 2701 RENAISSANCE BLVD FL 4
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City | KING OF PRUSSIA
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State | PA
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Zip | 19406-2781
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Country | US
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Telephone | 484-803-9663
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Fax | 484-393-4096
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Authorized Official
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Title or Position | DIRECTOR, PATIENT ACCOUNTS
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Name | MARK GALLIHUE
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Credential |
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Telephone | 610-994-2968
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2800X
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Taxonomy Name | Methadone Clinic
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License Number |
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License Number State |
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