Provider Demographics
NPI:1982238184
Name:TMR MENTAL HEALTH CARE PC
Entity type:Organization
Organization Name:TMR MENTAL HEALTH CARE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TASIA
Authorized Official - Middle Name:
Authorized Official - Last Name:MILICEVIC
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-528-5757
Mailing Address - Street 1:PO BOX 924
Mailing Address - Street 2:
Mailing Address - City:MAYWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07607-0924
Mailing Address - Country:US
Mailing Address - Phone:201-528-5757
Mailing Address - Fax:
Practice Address - Street 1:861 MAIN ST STE 1
Practice Address - Street 2:
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601-4907
Practice Address - Country:US
Practice Address - Phone:551-404-9677
Practice Address - Fax:800-322-3738
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-26
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-SpecialtyGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No133VN1201XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Obesity and Weight ManagementGroup - Multi-Specialty
No364SP0808XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental HealthGroup - Multi-Specialty