Provider Demographics
NPI:1184433542
Name:COPACETICA MENTAL HEALTH SERVICES LLC
Entity type:Organization
Organization Name:COPACETICA MENTAL HEALTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:LLOYD
Authorized Official - Last Name:HYLTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-376-6492
Mailing Address - Street 1:83 NOTTINGHAM SQ
Mailing Address - Street 2:
Mailing Address - City:HACKETTSTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07840-4225
Mailing Address - Country:US
Mailing Address - Phone:407-702-0476
Mailing Address - Fax:
Practice Address - Street 1:83 NOTTINGHAM SQ
Practice Address - Street 2:
Practice Address - City:HACKETTSTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07840-4225
Practice Address - Country:US
Practice Address - Phone:407-702-0476
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-31
Last Update Date:2024-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty