Provider Demographics
NPI:1629331954
Name:ASSURANCE BEHAVIORAL HEALTHCARE
Entity Type:Organization
Organization Name:ASSURANCE BEHAVIORAL HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CLARA
Authorized Official - Middle Name:LUISA
Authorized Official - Last Name:GREEN
Authorized Official - Suffix:IV
Authorized Official - Credentials:
Authorized Official - Phone:856-528-2207
Mailing Address - Street 1:103 E GATE DRIVE
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08034-2803
Mailing Address - Country:US
Mailing Address - Phone:856-528-2207
Mailing Address - Fax:856-528-2437
Practice Address - Street 1:36 KRESSON RD
Practice Address - Street 2:SUITE D
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08034-3227
Practice Address - Country:US
Practice Address - Phone:856-528-2207
Practice Address - Fax:856-528-2437
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-21
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health