Provider Demographics
NPI:1104959287
Name:ADVENT BEHAVIORAL CLINICS, LLC
Entity type:Organization
Organization Name:ADVENT BEHAVIORAL CLINICS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RUBY
Authorized Official - Middle Name:
Authorized Official - Last Name:ABRAHAM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-738-4209
Mailing Address - Street 1:720 KING GEORGE RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:FORDS
Mailing Address - State:NJ
Mailing Address - Zip Code:08863-1974
Mailing Address - Country:US
Mailing Address - Phone:732-738-4209
Mailing Address - Fax:
Practice Address - Street 1:720 KING GEORGE RD
Practice Address - Street 2:SUITE 102
Practice Address - City:FORDS
Practice Address - State:NJ
Practice Address - Zip Code:08863-1974
Practice Address - Country:US
Practice Address - Phone:732-738-4209
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA 724292084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty