Provider Demographics
NPI:1447525597
Name:GREATER TRENTON BEHAVIORAL HEALTHCARE
Entity type:Organization
Organization Name:GREATER TRENTON BEHAVIORAL HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:JENINE
Authorized Official - Middle Name:MICHELE
Authorized Official - Last Name:BLOUNT
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:609-396-8877
Mailing Address - Street 1:8 MERSHON LN
Mailing Address - Street 2:
Mailing Address - City:PLAINSBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:08536-1123
Mailing Address - Country:US
Mailing Address - Phone:609-799-6472
Mailing Address - Fax:609-396-6024
Practice Address - Street 1:2550 BRUNSWICK PIKE
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08648-4103
Practice Address - Country:US
Practice Address - Phone:609-396-8877
Practice Address - Fax:609-396-6024
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-21
Last Update Date:2012-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00426300251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health