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General NPI Number Information
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NPI Number | 1720737745
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Entity Type | Organization
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Legal Business Name | ADVANCED BEHAVIORAL HEALTH SERVICES, LLC
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Dates
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Enumeration Date | 03/18/2022
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Last Update Date | 11/18/2022
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Provider Practice Location Address
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Address Line | 591 MANTUA BLVD STE 201
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City | SEWELL
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State | NJ
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Zip | 08080-1032
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Country | US
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Telephone | 856-625-9194
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Fax | 856-644-4599
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Provider Business Mailing Address
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Address Line | PO BOX 236
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City | WENONAH
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State | NJ
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Zip | 08090-0236
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Country | US
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Telephone | 856-625-9194
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Fax | 856-644-4599
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Authorized Official
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Title or Position | THERAPIST, CEO
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Name | LALI BINDER
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Credential | LPC
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Telephone | 856-625-9194
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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 |
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License Number State |
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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 |
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License Number State |
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