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General NPI Number Information
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NPI Number | 1821469966
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Entity Type | Organization
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Legal Business Name | PRIME HEALTHCARE SERVICES - SAINT CLARE'S LLC
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Dates
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Enumeration Date | 10/15/2015
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Last Update Date | 10/15/2015
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Provider Practice Location Address
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Address Line | 50 MORRIS AVE
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City | DENVILLE
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State | NJ
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Zip | 07834-1735
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Country | US
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Telephone | 973-983-1524
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Fax | 973-983-1688
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Provider Business Mailing Address
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Address Line | 3300 E GUASTI RD THIRD FLOOR
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City | ONTARIO
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State | CA
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Zip | 91761-8655
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Country | US
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Telephone | 909-235-4300
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Fax | 909-235-4419
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Authorized Official
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Title or Position | CHIEF FINANCIAL OFFICER
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Name | MICHAEL HEATHER
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Credential |
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Telephone | 909-235-4300
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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 |
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