| Organization Name: | ST REMI LLC |
| NPI Number: | 1144583519 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ISIAKA ABAYOMI BOLARINWA (PRESIDENT/ MEDICAL DIRECTOR) |
| Mailing Address: | 141 S Black Horse Pike Suite 104 Blackwood |
| State: | NJ US |
| Postal Code: | 080122975 |
| Phone Number: | 8563410477 |
| Fax Number: | 8568854471 |
| NPI Enumeration Date: | 06/20/2012 |
| NPI Last Update Date: | 10/09/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2084P0804X |
| License Number: | MA072697 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NJ |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Psychiatry & Neurology |
| Taxonomy Specialization: | Child & Adolescent Psychiatry |
| Taxonomy Definition: | Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence. |