Provider Demographics
NPI:1144548389
Name:CPC BEHAVIORAL HEALTHCARE, INC
Entity type:Organization
Organization Name:CPC BEHAVIORAL HEALTHCARE, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PATIENT ACCT MGR
Authorized Official - Prefix:MS
Authorized Official - First Name:STELLA
Authorized Official - Middle Name:
Authorized Official - Last Name:SANTORA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-935-2260
Mailing Address - Street 1:10 INDUSTRIAL WAY E
Mailing Address - Street 2:
Mailing Address - City:EATONTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07724-3332
Mailing Address - Country:US
Mailing Address - Phone:732-935-2220
Mailing Address - Fax:732-389-3207
Practice Address - Street 1:1 HIGH POINT CENTER WAY
Practice Address - Street 2:
Practice Address - City:MORGANVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07751-4213
Practice Address - Country:US
Practice Address - Phone:732-591-1750
Practice Address - Fax:732-389-3207
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-12
Last Update Date:2010-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7651104Medicaid
NJ0017752Medicaid
NJ0012017Medicaid
NJ0085502Medicaid
NJ8835306Medicaid
NJ0012068Medicaid
NJ0012025Medicaid
NJ4547036Medicaid
NJ8378207Medicaid
NJ8819408Medicaid
NJ0017175Medicaid
NJ0099805Medicaid
NJ8378509Medicaid
NJ0085502Medicaid
NJ0012025Medicaid