Provider First Line Business Practice Location Address:
655 E JERSEY ST
Provider Second Line Business Practice Location Address:
DEPT OF BEHAVIORAL HEALTH & PSYCHIARTY
Provider Business Practice Location Address City Name:
ELIZABETH
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07206-1259
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
908-994-7455
Provider Business Practice Location Address Fax Number:
908-994-7457
Provider Enumeration Date:
01/05/2007