Provider Demographics
NPI:1851066682
Name:ALLWOOD BEHAVIORAL HEALTH
Entity Type:Organization
Organization Name:ALLWOOD BEHAVIORAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SIMONA
Authorized Official - Middle Name:C
Authorized Official - Last Name:CASSATLY
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:973-495-5363
Mailing Address - Street 1:528 RIDGEWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:GLEN RIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07028-1823
Mailing Address - Country:US
Mailing Address - Phone:973-495-5363
Mailing Address - Fax:
Practice Address - Street 1:935 ALLWOOD RD STE 300
Practice Address - Street 2:
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07012-1988
Practice Address - Country:US
Practice Address - Phone:862-930-5700
Practice Address - Fax:973-707-2383
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-13
Last Update Date:2021-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health