Provider Demographics
NPI:1679166516
Name:RADD BEHAVIORAL HEALTH LLC
Entity Type:Organization
Organization Name:RADD BEHAVIORAL HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RANDY
Authorized Official - Middle Name:R
Authorized Official - Last Name:RADD
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:732-735-3558
Mailing Address - Street 1:PO BOX 217
Mailing Address - Street 2:
Mailing Address - City:KINGSTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08528-0217
Mailing Address - Country:US
Mailing Address - Phone:732-735-3558
Mailing Address - Fax:
Practice Address - Street 1:4499 ROUTE 27 STE 2
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:NJ
Practice Address - Zip Code:08540-8717
Practice Address - Country:US
Practice Address - Phone:732-735-3558
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-11
Last Update Date:2021-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty