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General NPI Number Information
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NPI Number | 1457837049
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Entity Type | Organization
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Legal Business Name | HEALING AT HIDDEN RIVER, LLC
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Dates
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Enumeration Date | 07/17/2018
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Last Update Date | 04/28/2023
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Provider Practice Location Address
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Address Line | 230 POTTERSVILLE RD
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City | CHESTER
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State | NJ
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Zip | 07930-2432
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Country | US
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Telephone | 561-719-9196
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Fax |
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Provider Business Mailing Address
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Address Line | 3710 BUCKEYE ST STE 100
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City | PALM BEACH GARDENS
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State | FL
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Zip | 33410-4290
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | CARLOS LUNA
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Credential |
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Telephone | 561-719-9196
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 323P00000X
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Taxonomy Name | Psychiatric Residential Treatment Facility
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License Number |
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License Number State |
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