Provider Demographics
NPI:1871670570
Name:MOUNT CARMEL GUILD
Entity Type:Organization
Organization Name:MOUNT CARMEL GUILD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TEAM LEADER
Authorized Official - Prefix:PROF
Authorized Official - First Name:CORINA
Authorized Official - Middle Name:E
Authorized Official - Last Name:HARTEN
Authorized Official - Suffix:
Authorized Official - Credentials:LMS
Authorized Official - Phone:201-558-3726
Mailing Address - Street 1:36 WESTSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:AVENEL
Mailing Address - State:NJ
Mailing Address - Zip Code:07001-1423
Mailing Address - Country:US
Mailing Address - Phone:732-726-9624
Mailing Address - Fax:
Practice Address - Street 1:2201 BERGENLINE AVE
Practice Address - Street 2:SECOND FLOOR
Practice Address - City:UNION CITY
Practice Address - State:NJ
Practice Address - Zip Code:07087-3582
Practice Address - Country:US
Practice Address - Phone:201-558-3700
Practice Address - Fax:201-392-5048
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL05323500251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health