Organization Name: | BE AT EASE |
NPI Number: | 1104061951 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | CAROLYN M KOSTERA (APN) |
Mailing Address: | 1125 Atlantic Ave Ste 105 Atlantic City |
State: | NJ US |
Postal Code: | 084014806 |
Phone Number: | 6093408200 |
Fax Number: | |
NPI Enumeration Date: | 12/09/2008 |
NPI Last Update Date: | 12/09/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QM0850X |
License Number: | 26NJ00102100 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NJ |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Adult Mental Health |
Taxonomy Definition: | An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults. |