Provider Demographics
NPI:1033828520
Name:RUTGERS-UNIVERSITY BEHAVIORAL HEALTH CARE
Entity Type:Organization
Organization Name:RUTGERS-UNIVERSITY BEHAVIORAL HEALTH CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RUTGERS UBHC - CFO
Authorized Official - Prefix:
Authorized Official - First Name:CARL
Authorized Official - Middle Name:W
Authorized Official - Last Name:O'BRIEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-235-5940
Mailing Address - Street 1:30 KNIGHTSBRIDGE RD STE 626
Mailing Address - Street 2:
Mailing Address - City:PISCATAWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:08854-3948
Mailing Address - Country:US
Mailing Address - Phone:732-235-5940
Mailing Address - Fax:
Practice Address - Street 1:8 MAIN ST
Practice Address - Street 2:
Practice Address - City:FLEMINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08822-1468
Practice Address - Country:US
Practice Address - Phone:732-235-5940
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-23
Last Update Date:2022-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health