Provider Demographics
NPI:1366497356
Name:CPC BEHAVIORAL HEALTHCARE, INC
Entity Type:Organization
Organization Name:CPC BEHAVIORAL HEALTHCARE, INC
Other - Org Name:CPC MENTAL HEALTH SERVICE, INC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:MANS
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:732-935-2220
Mailing Address - Street 1:10 INDUSTRIAL WAY E
Mailing Address - Street 2:
Mailing Address - City:EATONTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07724-3317
Mailing Address - Country:US
Mailing Address - Phone:732-935-2220
Mailing Address - Fax:732-389-3207
Practice Address - Street 1:270 ROUTE 35
Practice Address - Street 2:
Practice Address - City:RED BANK
Practice Address - State:NJ
Practice Address - Zip Code:07701-5920
Practice Address - Country:US
Practice Address - Phone:732-842-2000
Practice Address - Fax:732-224-0688
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-24
Last Update Date:2008-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0017752Medicaid
NJ8835306Medicaid
NJ4547306Medicaid
NJ8378509Medicaid
NJ8819408Medicaid
NJ0012025Medicaid
NJ0085502Medicaid
NJ7651104Medicaid
NJ0017175Medicaid
NJ0012017Medicaid
NJ8378207Medicaid
NJ0012068Medicaid
NJ0099805Medicaid
NJ0085502Medicaid
NJ0012068Medicaid
NJ8835306Medicaid