Provider Demographics
NPI:1982195400
Name:AMARI BEHAVIORAL HEALTH
Entity Type:Organization
Organization Name:AMARI BEHAVIORAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ADISA
Authorized Official - Middle Name:
Authorized Official - Last Name:ALGHALI
Authorized Official - Suffix:
Authorized Official - Credentials:EDD, LPC, ACS
Authorized Official - Phone:240-394-2101
Mailing Address - Street 1:39 MAIDEN LN
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07102-5800
Mailing Address - Country:US
Mailing Address - Phone:240-394-2101
Mailing Address - Fax:
Practice Address - Street 1:39 MAIDEN LN
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07102-5800
Practice Address - Country:US
Practice Address - Phone:240-394-2101
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-21
Last Update Date:2018-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00514200251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health