Provider Demographics
NPI:1619598968
Name:MOUNTAINSIDE - RAMSEY
Entity Type:Organization
Organization Name:MOUNTAINSIDE - RAMSEY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF BILLING
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-362-5232
Mailing Address - Street 1:500 N FRANKLIN TPKE STE 304
Mailing Address - Street 2:
Mailing Address - City:RAMSEY
Mailing Address - State:NJ
Mailing Address - Zip Code:07446-1160
Mailing Address - Country:US
Mailing Address - Phone:860-362-5232
Mailing Address - Fax:877-861-6507
Practice Address - Street 1:500 N FRANKLIN TPKE STE 304
Practice Address - Street 2:
Practice Address - City:RAMSEY
Practice Address - State:NJ
Practice Address - Zip Code:07446-1160
Practice Address - Country:US
Practice Address - Phone:860-362-5232
Practice Address - Fax:877-861-6507
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-28
Last Update Date:2020-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility