Provider Demographics
NPI:1891377503
Name:VANTAGE HEALTH SYSTEM
Entity Type:Organization
Organization Name:VANTAGE HEALTH SYSTEM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACCOUNT MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:BETTY
Authorized Official - Middle Name:
Authorized Official - Last Name:TRELOAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-385-4400
Mailing Address - Street 1:93 W PALISADE AVE
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07631-2611
Mailing Address - Country:US
Mailing Address - Phone:201-567-0500
Mailing Address - Fax:201-567-9335
Practice Address - Street 1:93 W PALISADE AVE
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07631-2611
Practice Address - Country:US
Practice Address - Phone:201-567-0500
Practice Address - Fax:201-567-9335
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-22
Last Update Date:2021-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251B00000XAgenciesCase Management
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty