Provider Demographics
NPI:1104374156
Name:TGH BEHAVIOR OF NEW JERSEY
Entity Type:Organization
Organization Name:TGH BEHAVIOR OF NEW JERSEY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:TONYA
Authorized Official - Middle Name:M
Authorized Official - Last Name:RANKIN
Authorized Official - Suffix:
Authorized Official - Credentials:BACHELORS DEGREE
Authorized Official - Phone:704-603-7703
Mailing Address - Street 1:2616 OLD WILKESBORO RD
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:NC
Mailing Address - Zip Code:28144-3073
Mailing Address - Country:US
Mailing Address - Phone:704-603-7703
Mailing Address - Fax:
Practice Address - Street 1:2616 OLD WILKESBORO RD
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:NC
Practice Address - Zip Code:28144-3073
Practice Address - Country:US
Practice Address - Phone:704-603-7703
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-20
Last Update Date:2016-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health