MEDICARE: VANTAGE HEALTH SYSTEM, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1518939917
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VANTAGE HEALTH SYSTEM, INC

Provider Business Mailing Address
First Line	:	2 PARK AVENUE
Second Line	:
City	:	DUMONT
State	:	NJ
Zip	:	07628
Country	:	US
Telephone Number	:	201-385-4400
Fax Number	:	201-384-7067

Provider Business Practice Location Address
First Line	:	2 PARK AVENUE
Second Line	:
City	:	DUMONT
State	:	NJ
Zip	:	07628
Country	:	US
Telephone Number	:	201-385-4400
Fax Number	:	201-384-7067

Authorized Official
Title or Position	:	CEO
Name	:	MR. DAVID GRIFFITH
Credential	:
Telephone Number	:	201-385-4400

Provider Enumeration Date	:	02/02/2006
Last Update Date	:	09/11/2019

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Directions to “VANTAGE HEALTH SYSTEM, INC ” Practice Location

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