Provider Demographics
NPI:1851756498
Name:TQ BEHAVIORAL HEALTH LLC
Entity Type:Organization
Organization Name:TQ BEHAVIORAL HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:HENRY
Authorized Official - Middle Name:
Authorized Official - Last Name:ODUNLAMI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:908-526-8370
Mailing Address - Street 1:1065 US HIGHWAY 22
Mailing Address - Street 2:SUITE 3B
Mailing Address - City:BRIDGEWATER
Mailing Address - State:NJ
Mailing Address - Zip Code:08807-2949
Mailing Address - Country:US
Mailing Address - Phone:908-526-8370
Mailing Address - Fax:908-801-6850
Practice Address - Street 1:940 CEDAR BRIDGE AVE
Practice Address - Street 2:SUITE B
Practice Address - City:BRICK
Practice Address - State:NJ
Practice Address - Zip Code:08723-4170
Practice Address - Country:US
Practice Address - Phone:908-526-8370
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-28
Last Update Date:2015-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA072910002084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty