Provider Demographics
NPI:1760921803
Name:CENTER FOR NETWORK THERAPY II INC
Entity Type:Organization
Organization Name:CENTER FOR NETWORK THERAPY II INC
Other - Org Name:CENTER FOR NETWORK THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:EDDIE
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:MANN
Authorized Official - Suffix:
Authorized Official - Credentials:LSW,LCADC,CCS
Authorized Official - Phone:732-560-1080
Mailing Address - Street 1:81 NORTHFIELD AVE
Mailing Address - Street 2:SUITE 104
Mailing Address - City:WEST ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07052-5342
Mailing Address - Country:US
Mailing Address - Phone:732-560-1080
Mailing Address - Fax:732-560-1081
Practice Address - Street 1:333 CEDAR AVE
Practice Address - Street 2:BUILDING B SUITE 3
Practice Address - City:MIDDLESEX
Practice Address - State:NJ
Practice Address - Zip Code:08846
Practice Address - Country:US
Practice Address - Phone:732-560-1080
Practice Address - Fax:732-560-1081
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CENTER FOR NETWORK THERAPY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-02-22
Last Update Date:2017-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ261QR0405261QR0405X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder