Basic Information
| Provider Information | |||||||||
| NPI: | 1013269216 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | COUNSELING CENTER AT FREEHOLD LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4345 ROUTE 9 N | ||||||||
| Address2: | |||||||||
| City: | FREEHOLD | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 077284215 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7324315300 | ||||||||
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| Practice Location | |||||||||
| Address1: | 4345 ROUTE 9 N | ||||||||
| Address2: | |||||||||
| City: | FREEHOLD | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 077284215 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7324315300 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/11/2012 | ||||||||
| LastUpdateDate: | 11/04/2022 | ||||||||
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| AuthorizedOfficialLastName: | BURNS | ||||||||
| AuthorizedOfficialFirstName: | LINDA | ||||||||
| AuthorizedOfficialMiddleName: | R | ||||||||
| AuthorizedOfficialTitleorPosition: | CHIEF NURSING OFFICER | ||||||||
| AuthorizedOfficialTelephone: | 7324315300 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | RN | ||||||||
| NPICertificationDate: | 11/04/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QR0405X | 2000454-12 | NJ | Y | Ambulatory Health Care Facilities | Clinic/Center | Rehabilitation, Substance Use Disorder |
No ID Information.