Organization Name: | THE CENTER FOR OPTIMUM LIVING, INC. |
NPI Number: | 1215082268 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | SALVATORE CHARLES BENANTI (DIRECTOR) |
Mailing Address: | 6 Hillside Rd Kinnelon |
State: | NJ US |
Postal Code: | 074052306 |
Phone Number: | 9738388375 |
Fax Number: | 9738380603 |
NPI Enumeration Date: | 01/23/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 37PC00100000 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NJ |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |