Provider Demographics
NPI:1215285291
Name:COMPREHENSIVE BEHAVIORAL HEALTHCARE
Entity type:Organization
Organization Name:COMPREHENSIVE BEHAVIORAL HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING SUPERVISOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:DANA
Authorized Official - Middle Name:J
Authorized Official - Last Name:JAWORSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-935-3322
Mailing Address - Street 1:516 VALLEY BROOK AVE
Mailing Address - Street 2:
Mailing Address - City:LYNDHURST
Mailing Address - State:NJ
Mailing Address - Zip Code:07071-1930
Mailing Address - Country:US
Mailing Address - Phone:201-935-3322
Mailing Address - Fax:201-935-3991
Practice Address - Street 1:516 VALLEY BROOK AVE
Practice Address - Street 2:
Practice Address - City:LYNDHURST
Practice Address - State:NJ
Practice Address - Zip Code:07071-1930
Practice Address - Country:US
Practice Address - Phone:201-935-3322
Practice Address - Fax:201-935-3991
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-22
Last Update Date:2012-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0107191Medicaid
NJ000963Medicare PIN