Provider Demographics
NPI:1376393587
Name:CHILD, ADOLESCENT AND ADULT PSYCHIATRIC CARE LLC
Entity Type:Organization
Organization Name:CHILD, ADOLESCENT AND ADULT PSYCHIATRIC CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE OWNER PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:SYED
Authorized Official - Middle Name:JAWAD
Authorized Official - Last Name:TIRMAZI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:848-999-9756
Mailing Address - Street 1:42 N GRANT AVE
Mailing Address - Street 2:
Mailing Address - City:COLONIA
Mailing Address - State:NJ
Mailing Address - Zip Code:07067-2208
Mailing Address - Country:US
Mailing Address - Phone:848-999-9756
Mailing Address - Fax:
Practice Address - Street 1:42 N GRANT AVE
Practice Address - Street 2:
Practice Address - City:COLONIA
Practice Address - State:NJ
Practice Address - Zip Code:07067-2208
Practice Address - Country:US
Practice Address - Phone:848-999-9756
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-22
Last Update Date:2024-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health