Provider Demographics
NPI:1114045523
Name:VANTAGE HEALTH SYSTEM
Entity Type:Organization
Organization Name:VANTAGE HEALTH SYSTEM
Other - Org Name:TOUCHSTONE HALL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:
Authorized Official - First Name:VICTORIA
Authorized Official - Middle Name:L
Authorized Official - Last Name:SIDROW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-385-4400
Mailing Address - Street 1:35D PIERMONT ROAD
Mailing Address - Street 2:
Mailing Address - City:ROCKLEIGH
Mailing Address - State:NJ
Mailing Address - Zip Code:07647
Mailing Address - Country:US
Mailing Address - Phone:201-784-6490
Mailing Address - Fax:201-784-6495
Practice Address - Street 1:35D PIERMONT ROAD
Practice Address - Street 2:
Practice Address - City:ROCKLEIGH
Practice Address - State:NJ
Practice Address - Zip Code:07647
Practice Address - Country:US
Practice Address - Phone:201-784-6490
Practice Address - Fax:201-784-6495
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-26
Last Update Date:2013-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22691324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility