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General NPI Number Information
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NPI Number | 1679166516
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Entity Type | Organization
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Legal Business Name | RADD BEHAVIORAL HEALTH LLC
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Dates
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Enumeration Date | 02/11/2021
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Last Update Date | 02/11/2021
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Provider Practice Location Address
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Address Line | 4499 ROUTE 27 STE 2
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City | PRINCETON
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State | NJ
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Zip | 08540-8717
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Country | US
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Telephone | 732-735-3558
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 217
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City | KINGSTON
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State | NJ
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Zip | 08528-0217
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Country | US
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Telephone | 732-735-3558
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | RANDY R RADD
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Credential | LCSW
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Telephone | 732-735-3558
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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