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General NPI Number Information
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NPI Number | 1528501335
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Entity Type | Organization
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Legal Business Name | MENTAL HEALTH ASSOCIATION IN PASSAIC COUNTY
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Dates
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Enumeration Date | 11/28/2016
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Last Update Date | 12/04/2024
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Provider Practice Location Address
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Address Line | 404 CLIFTON AVE.
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City | CLIFTON
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State | NJ
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Zip | 07011
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Country | US
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Telephone | 973-478-4444
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Fax | 973-478-0941
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Provider Business Mailing Address
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Address Line | 404 CLIFTON AVE
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City | CLIFTON
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State | NJ
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Zip | 07011
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Country | US
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Telephone | 973-478-4444
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Fax | 973-478-0941
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MS. REBEKAH LEON
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Credential |
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Telephone | 973-478-4444
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number | 101080104
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License Number State | NJ
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