Organization Name: | NEW AGE PSYCHIATRY LLC |
NPI Number: | 1023430600 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | SAFEER A ANSARI (DOCTOR) |
Mailing Address: | 480 Jackson Rd Atco |
State: | NJ US |
Postal Code: | 080041651 |
Phone Number: | 8567675020 |
Fax Number: | 8567683541 |
NPI Enumeration Date: | 01/15/2014 |
NPI Last Update Date: | 01/15/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 320800000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Residential Treatment Facilities |
Taxonomy Classification: | Community Based Residential Treatment Facility, Mental Illness |
Taxonomy Specialization: | |
Taxonomy Definition: | A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. |