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General NPI Number Information
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NPI Number | 1992378665
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Entity Type | Organization
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Legal Business Name | JAMES P NELSON BEHAVIORAL HEALTHCARE, LLC
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Dates
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Enumeration Date | 07/21/2021
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Last Update Date | 06/11/2025
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Provider Practice Location Address
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Address Line | 61 ESSEX AVE
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City | MAPLEWOOD
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State | NJ
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Zip | 07040-1534
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Country | US
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Telephone | 908-265-6569
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Fax |
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Provider Business Mailing Address
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Address Line | 61 ESSEX AVE
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City | MAPLEWOOD
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State | NJ
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Zip | 07040-1534
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Country | US
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Telephone | 908-265-6569
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | MS. KYESHA HEADD
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Credential | LCSW
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Telephone | 908-265-6569
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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 |
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