Provider Demographics
NPI:1215515374
Name:PREFERRED BEHAVIORAL HEALTH OF NEW JERSEY, INC
Entity type:Organization
Organization Name:PREFERRED BEHAVIORAL HEALTH OF NEW JERSEY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:
Authorized Official - Last Name:VANORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-458-1700
Mailing Address - Street 1:PO BOX 2036
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-8036
Mailing Address - Country:US
Mailing Address - Phone:732-663-1800
Mailing Address - Fax:
Practice Address - Street 1:40 CHRISTOPHER WAY
Practice Address - Street 2:
Practice Address - City:EATONTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07724-3327
Practice Address - Country:US
Practice Address - Phone:732-663-1800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-31
Last Update Date:2023-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ203022004OtherNJ DMHAS
NJ0824071Medicaid