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General NPI Number Information
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NPI Number | 1619009701
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Entity Type | Organization
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Legal Business Name | MENTAL HEALTH CLINIC OF PASSAIC INC
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Dates
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Enumeration Date | 03/12/2007
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Last Update Date | 04/20/2018
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Provider Practice Location Address
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Address Line | 1451 VAN HOUTEN AVE
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City | CLIFTON
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State | NJ
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Zip | 07013-2432
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Country | US
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Telephone | 973-473-2775
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Fax | 973-473-3625
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Provider Business Mailing Address
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Address Line | 1451 VAN HOUTEN AVE
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City | CLIFTON
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State | NJ
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Zip | 07013-2432
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Country | US
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Telephone | 973-473-2775
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Fax | 973-473-3625
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | DR. SYBIL SCHREIBER
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Credential | D.SW
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Telephone | 973-473-2775
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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 | 304050204
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License Number State | NJ
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