Provider Demographics
NPI:1992060099
Name:ACCESS CENTER BEHAVIORAL HEALTH NETWORK PC
Entity type:Organization
Organization Name:ACCESS CENTER BEHAVIORAL HEALTH NETWORK PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:HENRY
Authorized Official - Middle Name:
Authorized Official - Last Name:ODUNLAMI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:908-526-8370
Mailing Address - Street 1:10 FINDERNE AVE
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:BRIDGEWATER
Mailing Address - State:NJ
Mailing Address - Zip Code:08807-3365
Mailing Address - Country:US
Mailing Address - Phone:908-526-8370
Mailing Address - Fax:908-450-1233
Practice Address - Street 1:981 US HIGHWAY 22
Practice Address - Street 2:SUITE 104
Practice Address - City:BRIDGEWATER
Practice Address - State:NJ
Practice Address - Zip Code:08807-2946
Practice Address - Country:US
Practice Address - Phone:908-526-8370
Practice Address - Fax:908-450-1233
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-05
Last Update Date:2012-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA27910002084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty