Provider Demographics
NPI:1225517204
Name:MENTAL HEALTH ASSOCIATION OF ESSEX AND MORRIS
Entity Type:Organization
Organization Name:MENTAL HEALTH ASSOCIATION OF ESSEX AND MORRIS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:NADINE
Authorized Official - Middle Name:
Authorized Official - Last Name:VENEZIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-509-9777
Mailing Address - Street 1:33 S FULLERTON AVE
Mailing Address - Street 2:
Mailing Address - City:MONTCLAIR
Mailing Address - State:NJ
Mailing Address - Zip Code:07042-3358
Mailing Address - Country:US
Mailing Address - Phone:973-509-9777
Mailing Address - Fax:
Practice Address - Street 1:530 MAIN AVE
Practice Address - Street 2:
Practice Address - City:PASSAIC
Practice Address - State:NJ
Practice Address - Zip Code:07055-5700
Practice Address - Country:US
Practice Address - Phone:973-470-3522
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-09
Last Update Date:2018-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health