Provider Demographics
NPI:1962682989
Name:THE CENTER FOR NEUROLOGICAL AND NEURODEVELOPMENTAL HEALTH, LLC
Entity Type:Organization
Organization Name:THE CENTER FOR NEUROLOGICAL AND NEURODEVELOPMENTAL HEALTH, LLC
Other - Org Name:CNNH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:CLEMONS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-346-0005
Mailing Address - Street 1:2050 VOORHEES TOWN CENTER
Mailing Address - Street 2:
Mailing Address - City:VOORHEES
Mailing Address - State:NJ
Mailing Address - Zip Code:08043-3512
Mailing Address - Country:US
Mailing Address - Phone:856-346-0005
Mailing Address - Fax:
Practice Address - Street 1:2050 VOORHEES TOWN CENTER
Practice Address - Street 2:
Practice Address - City:VOORHEES
Practice Address - State:NJ
Practice Address - Zip Code:08043-3806
Practice Address - Country:US
Practice Address - Phone:856-346-0005
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-07
Last Update Date:2022-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Multi-Specialty