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General NPI Number Information
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NPI Number | 1649659426
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Entity Type | Organization
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Legal Business Name | BEACON BEHAVIORAL HEALTH SERVICES
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Dates
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Enumeration Date | 05/26/2015
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Last Update Date | 05/26/2015
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Provider Practice Location Address
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Address Line | 154 COOPER RD SUITE 801
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City | WEST BERLIN
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State | NJ
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Zip | 08091-9128
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Country | US
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Telephone | 856-767-1565
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Fax | 856-767-4615
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Provider Business Mailing Address
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Address Line | 154 COOPER RD SUITE 801
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City | WEST BERLIN
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State | NJ
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Zip | 08091-9128
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Country | US
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Telephone | 856-767-1565
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Fax | 856-767-4615
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. NICHOLAS MCCLARY
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Credential | MSW
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Telephone | 856-767-1565
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State | NJ
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