Provider Demographics
NPI:1871920306
Name:UNIVERSITY BEHAVIORAL HEALTH CARE
Entity type:Organization
Organization Name:UNIVERSITY BEHAVIORAL HEALTH CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT AND CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:KOSSEFF
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:732-235-5900
Mailing Address - Street 1:671 HOES LN W
Mailing Address - Street 2:
Mailing Address - City:PISCATAWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:08854-8021
Mailing Address - Country:US
Mailing Address - Phone:732-235-5900
Mailing Address - Fax:609-341-9380
Practice Address - Street 1:1 WHITTLESEY RD
Practice Address - Street 2:BATES BUILDING
Practice Address - City:TRENTON
Practice Address - State:NJ
Practice Address - Zip Code:08618-3479
Practice Address - Country:US
Practice Address - Phone:609-292-4036
Practice Address - Fax:609-341-9380
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RUTGERS, THE STATE UNIVERSITY OF NEW JERSEY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-09-30
Last Update Date:2013-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC00159200251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health