Provider Demographics
NPI:1275158529
Name:RETREAT & RECOVERY AT RAMAPO VALLEY
Entity Type:Organization
Organization Name:RETREAT & RECOVERY AT RAMAPO VALLEY
Other - Org Name:HMH CARRIER CLINIC, INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO/VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RANDOLPH
Authorized Official - Middle Name:S
Authorized Official - Last Name:JACOBSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-281-1000
Mailing Address - Street 1:252 COUNTY RTE 601
Mailing Address - Street 2:
Mailing Address - City:BELLE MEAD
Mailing Address - State:NJ
Mailing Address - Zip Code:08502
Mailing Address - Country:US
Mailing Address - Phone:908-281-1000
Mailing Address - Fax:908-281-1676
Practice Address - Street 1:1071 RAMAPO VALLEY RD
Practice Address - Street 2:
Practice Address - City:MAHWAH
Practice Address - State:NJ
Practice Address - Zip Code:07430
Practice Address - Country:US
Practice Address - Phone:833-734-0171
Practice Address - Fax:908-281-1676
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HMH CARRIER CLINIC, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-06-12
Last Update Date:2020-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283Q00000XHospitalsPsychiatric Hospital