Provider Demographics
NPI:1851435259
Name:ADVANCED BEHAVIORAL CARE SERVICES, LLC
Entity Type:Organization
Organization Name:ADVANCED BEHAVIORAL CARE SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:YOHANAN
Authorized Official - Middle Name:
Authorized Official - Last Name:DANZIGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-620-6116
Mailing Address - Street 1:5 AIRPORT RD
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-6902
Mailing Address - Country:US
Mailing Address - Phone:732-961-9666
Mailing Address - Fax:732-961-9066
Practice Address - Street 1:645 NEPTUNE BLVD
Practice Address - Street 2:
Practice Address - City:NEPTUNE
Practice Address - State:NJ
Practice Address - Zip Code:07753-4118
Practice Address - Country:US
Practice Address - Phone:732-961-9066
Practice Address - Fax:732-961-9066
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0005703Medicaid