Provider Demographics
NPI:1891088167
Name:LESTER A. DRENK BEHAVIORAL HEALTH CENTER, INC.
Entity type:Organization
Organization Name:LESTER A. DRENK BEHAVIORAL HEALTH CENTER, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MRS
Authorized Official - First Name:BETTY
Authorized Official - Middle Name:
Authorized Official - Last Name:GARRISON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-267-5656
Mailing Address - Street 1:1289 ROUTE 38 WEST
Mailing Address - Street 2:SUITE 203
Mailing Address - City:HAINESPORT
Mailing Address - State:NJ
Mailing Address - Zip Code:08036
Mailing Address - Country:US
Mailing Address - Phone:609-267-5656
Mailing Address - Fax:609-265-1895
Practice Address - Street 1:1289 ROUTE 38 WEST
Practice Address - Street 2:SUITE 203
Practice Address - City:HAINESPORT
Practice Address - State:NJ
Practice Address - Zip Code:08036
Practice Address - Country:US
Practice Address - Phone:609-267-5656
Practice Address - Fax:609-265-1895
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-19
Last Update Date:2011-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children