Full Name | Park Place |
---|---|
Speciality | Clinic/center - Adult Mental Health |
Location | 1011 Bond St, Asbury Park, New Jersey |
Authorized Official Name and Position | Susan M Affa (SOCIAL WORKER/INTAKE COORDINATOR) |
Authorized Official Contact | 7328692769 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Park Place 1011 Bond St Asbury Park NJ 07712-5939 Ph: (732) 869-2769 | Park Place 1011 Bond St Asbury Park NJ 07712-5939 Ph: (732) 869-2769 |
NPI Number | 1770836025 |
---|---|
Provider Enumeration Date | 10/24/2012 |
Last Update Date | 10/24/2012 |
Identifier | Type | State | Issuer |
---|---|---|---|
1770836025 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QM0850X | Clinic/center - Adult Mental Health | 44SL05734800 (New Jersey) | Primary |
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