Provider Demographics
NPI:1437366127
Name:EAST MOUNTAIN HOSPITAL, INC.
Entity Type:Organization
Organization Name:EAST MOUNTAIN HOSPITAL, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:F
Authorized Official - Last Name:VOORHEES
Authorized Official - Suffix:
Authorized Official - Credentials:RNC MS
Authorized Official - Phone:908-281-1439
Mailing Address - Street 1:252 COUNTY ROAD 601
Mailing Address - Street 2:
Mailing Address - City:BELLE MEAD
Mailing Address - State:NJ
Mailing Address - Zip Code:08502-3923
Mailing Address - Country:US
Mailing Address - Phone:908-281-1270
Mailing Address - Fax:908-281-1339
Practice Address - Street 1:252 COUNTY ROAD 601
Practice Address - Street 2:
Practice Address - City:BELLE MEAD
Practice Address - State:NJ
Practice Address - Zip Code:08502-3923
Practice Address - Country:US
Practice Address - Phone:908-281-1270
Practice Address - Fax:908-281-1339
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-16
Last Update Date:2009-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ229702084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0001694Medicaid
NJ0001694Medicaid