Provider Demographics
NPI:1578275046
Name:CONSTANCE HEALTH AND BEHAVIORAL CONSULT
Entity Type:Organization
Organization Name:CONSTANCE HEALTH AND BEHAVIORAL CONSULT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTIANAH
Authorized Official - Middle Name:
Authorized Official - Last Name:ADELAKUN
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:862-588-6125
Mailing Address - Street 1:261 CARNEGIE PL
Mailing Address - Street 2:
Mailing Address - City:VAUXHALL
Mailing Address - State:NJ
Mailing Address - Zip Code:07088-1334
Mailing Address - Country:US
Mailing Address - Phone:862-588-6125
Mailing Address - Fax:
Practice Address - Street 1:261 CARNEGIE PL
Practice Address - Street 2:
Practice Address - City:VAUXHALL
Practice Address - State:NJ
Practice Address - Zip Code:07088-1334
Practice Address - Country:US
Practice Address - Phone:862-588-6125
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-15
Last Update Date:2022-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)