| Organization Name: | BENCIVENNE INSTITUTE FOR BEHAVIORAL HEALTH, LLC |
| NPI Number: | 1023101748 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JOSEPH CHARLES BENCIVENNE (OWNER) |
| Mailing Address: | 1255 Broad Street Suite 206 Bloomfield |
| State: | NJ US |
| Postal Code: | 07003 |
| Phone Number: | 9737719000 |
| Fax Number: | 9737719100 |
| NPI Enumeration Date: | 10/02/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TB0200X |
| License Number: | 35S100392200 |
| Healthcare Provider Taxonomy: (Secondary) | X |
| State: | NJ |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Cognitive & Behavioral |
| Taxonomy Definition: | |