Provider Demographics
NPI:1790856375
Name:MOUNT CARMEL GUILD BEHAVIORAL HEALTH
Entity Type:Organization
Organization Name:MOUNT CARMEL GUILD BEHAVIORAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ESSEX COUNTY REGIONAL DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARGERY
Authorized Official - Middle Name:ALICE
Authorized Official - Last Name:GRIMM DEFRANCO
Authorized Official - Suffix:
Authorized Official - Credentials:MA LRC
Authorized Official - Phone:973-596-3971
Mailing Address - Street 1:86 WOODLAND RD
Mailing Address - Street 2:APARTMENT 1
Mailing Address - City:SHORT HILLS
Mailing Address - State:NJ
Mailing Address - Zip Code:07078-2435
Mailing Address - Country:US
Mailing Address - Phone:973-218-0292
Mailing Address - Fax:
Practice Address - Street 1:1160 RAYMOND BLVD
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07102-4168
Practice Address - Country:US
Practice Address - Phone:973-596-3971
Practice Address - Fax:973-596-3869
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37RC00155500283Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283Q00000XHospitalsPsychiatric Hospital