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General NPI Number Information
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NPI Number | 1538511639
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Entity Type | Organization
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Legal Business Name | VANTAGE HEALTH SYSTEM
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Dates
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Enumeration Date | 07/13/2016
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Last Update Date | 09/11/2019
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Provider Practice Location Address
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Address Line | 2 PARK AVE
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City | DUMONT
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State | NJ
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Zip | 07628-3004
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Country | US
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Telephone | 201-385-4400
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Fax | 201-385-2309
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Provider Business Mailing Address
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Address Line | 2 PARK AVE
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City | DUMONT
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State | NJ
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Zip | 07628-3004
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Country | US
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Telephone | 201-385-4400
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Fax | 201-385-2309
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Authorized Official
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Title or Position | CEO
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Name | MR. DAVID GRIFFITH
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Credential |
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Telephone | 201-385-4400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 923550204
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 923550104
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License Number State | NJ
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