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General NPI Number Information
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NPI Number | 1881958817
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Entity Type | Organization
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Legal Business Name | BUDDIES OF NEW JERSEY, INC.
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Dates
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Enumeration Date | 06/25/2012
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Last Update Date | 06/25/2012
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Provider Practice Location Address
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Address Line | 61 GRAND AVE 3RD FLOOR
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City | ENGLEWOOD
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State | NJ
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Zip | 07631-3572
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Country | US
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Telephone | 914-671-3924
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Fax | 845-942-1894
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Provider Business Mailing Address
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Address Line | 149 HUDSON ST
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City | HACKENSACK
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State | NJ
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Zip | 07601-6823
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Country | US
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Telephone | 201-489-2900
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Fax | 201-489-2133
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. MARK S. ANDERSON
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Credential | M.A.
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Telephone | 201-489-2900
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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 |
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License Number State | NJ
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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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