Provider Demographics
NPI:1215101753
Name:CPC BEHAVIORAL HEALTHCARE
Entity type:Organization
Organization Name:CPC BEHAVIORAL HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PATIENT ACCTS MGR
Authorized Official - Prefix:
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:732-395-2260
Mailing Address - Fax:732-389-3207
Practice Address - Street 1:1088 HIGHWAY 34
Practice Address - Street 2:
Practice Address - City:ABERDEEN
Practice Address - State:NJ
Practice Address - Zip Code:07747-1948
Practice Address - Country:US
Practice Address - Phone:732-290-1700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-16
Last Update Date:2008-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ701378OtherMEDICARE PROVIDER #
NJ540055OtherMEDICARE PROVIDER #