Provider Demographics
NPI:1598816993
Name:DISCOVERY BEHAVIORAL HEALTH
Entity Type:Organization
Organization Name:DISCOVERY BEHAVIORAL HEALTH
Other - Org Name:DSCOVERY HOUSE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:D
Authorized Official - Last Name:OH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-255-9411
Mailing Address - Street 1:1749 HOOPER AVE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08753-8130
Mailing Address - Country:US
Mailing Address - Phone:732-255-9411
Mailing Address - Fax:732-255-9424
Practice Address - Street 1:134 GRAND AVE
Practice Address - Street 2:
Practice Address - City:LEONIA
Practice Address - State:NJ
Practice Address - Zip Code:07605-2006
Practice Address - Country:US
Practice Address - Phone:201-969-1722
Practice Address - Fax:201-969-1754
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DONALD D.OH,M.D.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-01-15
Last Update Date:2008-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJCN#860526-21-14261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0040207Medicaid
NJ0040215Medicaid
NJ0040215Medicaid