Provider Demographics
NPI:1194007385
Name:HAMILTON MEDICALLY ASSISTED TREATMENT ASSOCIATES
Entity Type:Organization
Organization Name:HAMILTON MEDICALLY ASSISTED TREATMENT ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:BEVELL
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:561-577-3174
Mailing Address - Street 1:1799 KLOCKNER RD
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08619-2760
Mailing Address - Country:US
Mailing Address - Phone:609-207-7133
Mailing Address - Fax:
Practice Address - Street 1:1799 KLOCKNER RD
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:NJ
Practice Address - Zip Code:08619-2760
Practice Address - Country:US
Practice Address - Phone:609-207-7133
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-13
Last Update Date:2011-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ1111261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)