Provider Demographics
NPI:1396178430
Name:TRUE CARE MENTAL HEALTH CLINIC LLC
Entity Type:Organization
Organization Name:TRUE CARE MENTAL HEALTH CLINIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:ADELAKUN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-977-2000
Mailing Address - Street 1:9 W BROADWAY FL 2
Mailing Address - Street 2:
Mailing Address - City:PATERSON
Mailing Address - State:NJ
Mailing Address - Zip Code:07505-1014
Mailing Address - Country:US
Mailing Address - Phone:973-977-2000
Mailing Address - Fax:973-977-2005
Practice Address - Street 1:9 W BROADWAY FL 2
Practice Address - Street 2:
Practice Address - City:PATERSON
Practice Address - State:NJ
Practice Address - Zip Code:07505-1014
Practice Address - Country:US
Practice Address - Phone:973-977-2000
Practice Address - Fax:973-977-2005
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-13
Last Update Date:2020-03-30
Deactivation Date:2019-01-23
Deactivation Code:
Reactivation Date:2019-08-07
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental HealthGroup - Multi-Specialty
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ=========Medicaid