Provider Demographics
NPI:1467985838
Name:ATLANTICARE BEHAVIORAL HEALTH, INC.
Entity Type:Organization
Organization Name:ATLANTICARE BEHAVIORAL HEALTH, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SYSTEM EXEC. DIR. BEHAVE. HEALTH
Authorized Official - Prefix:
Authorized Official - First Name:JULIA
Authorized Official - Middle Name:
Authorized Official - Last Name:DREW
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW, MPA
Authorized Official - Phone:609-645-7600
Mailing Address - Street 1:6550 DELILAH RD STE 301
Mailing Address - Street 2:
Mailing Address - City:EGG HARBOR TOWNSHIP
Mailing Address - State:NJ
Mailing Address - Zip Code:08234-5102
Mailing Address - Country:US
Mailing Address - Phone:609-645-7600
Mailing Address - Fax:609-645-7343
Practice Address - Street 1:2511 FIRE RD STE B10
Practice Address - Street 2:
Practice Address - City:EGG HARBOR TOWNSHIP
Practice Address - State:NJ
Practice Address - Zip Code:08234-5655
Practice Address - Country:US
Practice Address - Phone:609-272-8580
Practice Address - Fax:609-645-7343
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-04
Last Update Date:2017-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ400050148251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0555088Medicaid