Provider Demographics
NPI:1497524607
Name:ROSE CENTER FOR COUPLE & PSYCHOLOGICAL GROWTH
Entity Type:Organization
Organization Name:ROSE CENTER FOR COUPLE & PSYCHOLOGICAL GROWTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/LICENSED PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:BAGLIERI
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:908-418-6104
Mailing Address - Street 1:223 HILLSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:CRANFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:07016-3409
Mailing Address - Country:US
Mailing Address - Phone:908-418-6104
Mailing Address - Fax:
Practice Address - Street 1:223 HILLSIDE AVE
Practice Address - Street 2:
Practice Address - City:CRANFORD
Practice Address - State:NJ
Practice Address - Zip Code:07016-3409
Practice Address - Country:US
Practice Address - Phone:908-418-6104
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-28
Last Update Date:2023-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty