Provider Demographics
NPI:1215202031
Name:ANCORA PSYCHIATRIC HOSPITAL
Entity Type:Organization
Organization Name:ANCORA PSYCHIATRIC HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:STAFF PSYCHOLOGIST 3
Authorized Official - Prefix:DR
Authorized Official - First Name:YOSHIKO
Authorized Official - Middle Name:
Authorized Official - Last Name:YAMAMOTO
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:609-561-1700
Mailing Address - Street 1:1600 LAUREL RD
Mailing Address - Street 2:APT B19
Mailing Address - City:LINDENWOLD
Mailing Address - State:NJ
Mailing Address - Zip Code:08021-6792
Mailing Address - Country:US
Mailing Address - Phone:856-761-4725
Mailing Address - Fax:
Practice Address - Street 1:1600 LAUREL RD
Practice Address - Street 2:APT B19
Practice Address - City:LINDENWOLD
Practice Address - State:NJ
Practice Address - Zip Code:08021-6792
Practice Address - Country:US
Practice Address - Phone:856-761-4725
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-12
Last Update Date:2012-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282E00000XHospitalsLong Term Care Hospital