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General NPI Number Information
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NPI Number | 1932584547
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Entity Type | Organization
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Legal Business Name | A HEALTHY MIND
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Dates
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Enumeration Date | 07/24/2015
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Last Update Date | 09/09/2015
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Provider Practice Location Address
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Address Line | 2130 MILLBURN AVE
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City | MAPLEWOOD
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State | NJ
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Zip | 07040-3725
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Country | US
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Telephone | 973-524-0591
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Fax |
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Provider Business Mailing Address
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Address Line | 852 VALLEY ST
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City | VAUXHALL
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State | NJ
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Zip | 07088-1204
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Country | US
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Telephone | 973-524-0591
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Fax |
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Authorized Official
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Title or Position | PSYCHIATRIST
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Name | DR. TOBECHUKWU CLOUDEN
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Credential | MD
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Telephone | 973-524-0591
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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 | 25MA08739900
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License Number State | NJ
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