Provider Demographics
NPI:1447810155
Name:TRENTON HEALTHCARE, LLC (WORKFIRST ONLY)
Entity type:Organization
Organization Name:TRENTON HEALTHCARE, LLC (WORKFIRST ONLY)
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR, PATIENT ACCOUNTS
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:GALLIHUE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-994-2968
Mailing Address - Street 1:2701 RENAISSANCE BLVD FL 4
Mailing Address - Street 2:
Mailing Address - City:KING OF PRUSSIA
Mailing Address - State:PA
Mailing Address - Zip Code:19406-2781
Mailing Address - Country:US
Mailing Address - Phone:484-803-9663
Mailing Address - Fax:484-393-4096
Practice Address - Street 1:801 NEW YORK AVE
Practice Address - Street 2:
Practice Address - City:TRENTON
Practice Address - State:NJ
Practice Address - Zip Code:08638-3913
Practice Address - Country:US
Practice Address - Phone:609-393-8000
Practice Address - Fax:609-393-8020
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-14
Last Update Date:2019-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2800XAmbulatory Health Care FacilitiesClinic/CenterMethadone