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NPI Code Detail

MEDICARE: MOUNT CARMEL GUILD BEHAVIORAL HEALTH

MEDICARE: MOUNT CARMEL GUILD BEHAVIORAL HEALTH
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
1261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)

Other Identifiers

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

General Provider Information

NPI Number : 1689074601
Entity Type Code : Organization
Provider Name (Legal Business Name) : MOUNT CARMEL GUILD BEHAVIORAL HEALTH
Provider Business Mailing Address
First Line : 590 N 7TH ST
Second Line :
City : NEWARK
State : NJ
Zip : 07107-2522
Country : US
Telephone Number : 973-596-5101
Fax Number : 973-485-1978
Provider Business Practice Location Address
First Line : 590 N 7TH ST
Second Line :
City : NEWARK
State : NJ
Zip : 07107-2522
Country : US
Telephone Number : 973-596-5101
Fax Number : 973-485-1978
Authorized Official
Title or Position : CEO
Name : MR. JOHN WESTERVELT
Credential :
Telephone Number : 973-596-7989
Provider Enumeration Date : 08/27/2014
Last Update Date : 08/27/2014

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Directions to “MOUNT CARMEL GUILD BEHAVIORAL HEALTH ” Practice Location

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