Provider Demographics
NPI:1184217580
Name:ACCORDIA BEHAVIORAL HEALTH LLC
Entity Type:Organization
Organization Name:ACCORDIA BEHAVIORAL HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:ODEY
Authorized Official - Last Name:OGON
Authorized Official - Suffix:SR
Authorized Official - Credentials:BSC
Authorized Official - Phone:609-227-9225
Mailing Address - Street 1:453 DORCHESTER DR
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:NJ
Mailing Address - Zip Code:08075-1369
Mailing Address - Country:US
Mailing Address - Phone:609-227-9225
Mailing Address - Fax:
Practice Address - Street 1:2 LEONARD AVE
Practice Address - Street 2:
Practice Address - City:CAMDEN
Practice Address - State:NJ
Practice Address - Zip Code:08105-2404
Practice Address - Country:US
Practice Address - Phone:609-227-9225
Practice Address - Fax:856-666-0159
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-16
Last Update Date:2021-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent PsychiatryGroup - Multi-Specialty
No103TA0400XBehavioral Health & Social Service ProvidersPsychologistAddiction (Substance Use Disorder)Group - Multi-Specialty