Provider Demographics
NPI:1659704864
Name:EDUCATIONAL & BEHAVIORAL HEALTH ASSOCIATES
Entity Type:Organization
Organization Name:EDUCATIONAL & BEHAVIORAL HEALTH ASSOCIATES
Other - Org Name:EBHA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MALDONADO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-410-7376
Mailing Address - Street 1:999 RIVERVIEW DR
Mailing Address - Street 2:
Mailing Address - City:TOTOWA
Mailing Address - State:NJ
Mailing Address - Zip Code:07512-1164
Mailing Address - Country:US
Mailing Address - Phone:973-406-5160
Mailing Address - Fax:
Practice Address - Street 1:999 RIVERVIEW DRIVE
Practice Address - Street 2:SUITE#201
Practice Address - City:TOTOWA
Practice Address - State:NJ
Practice Address - Zip Code:07512
Practice Address - Country:US
Practice Address - Phone:973-406-5160
Practice Address - Fax:973-406-5101
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-12
Last Update Date:2013-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health