Basic Information
| Provider Information | |||||||||
| NPI: | 1053880286 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | HMH HOSPITALS CORPORATION | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1200 JUMPING BROOK RD., BLDG 5, STE 201 | ||||||||
| Address2: | ATTN: BEHAVIORAL HEALTH CREDENTIALING | ||||||||
| City: | NEPTUNE | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 07753 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7326434372 | ||||||||
| FaxNumber: | 7326434376 | ||||||||
| Practice Location | |||||||||
| Address1: | 1200 JUMPING BROOK RD. | ||||||||
| Address2: | BLDG 5, STE 201 | ||||||||
| City: | NEPTUNE | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 07753 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7326434400 | ||||||||
| FaxNumber: | 7326434378 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/16/2018 | ||||||||
| LastUpdateDate: | 11/16/2018 | ||||||||
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| AuthorizedOfficialLastName: | KOCZAN | ||||||||
| AuthorizedOfficialFirstName: | MARILYN | ||||||||
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| AuthorizedOfficialTitleorPosition: | VP REVENUE CYCLE | ||||||||
| AuthorizedOfficialTelephone: | 7328977800 | ||||||||
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| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | HMH HOSPITALS CORPORATION | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261Q00000X | Y | Ambulatory Health Care Facilities | Clinic/Center |
No ID Information.