Provider Demographics
NPI:1245932177
Name:RUTGERS HEALTH - UNIVERSITY BEHAVIORAL HEALTH CARE
Entity type:Organization
Organization Name:RUTGERS HEALTH - UNIVERSITY BEHAVIORAL HEALTH CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RUTGERS UBHC - CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:CARL
Authorized Official - Middle Name:W
Authorized Official - Last Name:O'BRIEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-235-5940
Mailing Address - Street 1:671 HOES LN W
Mailing Address - Street 2:
Mailing Address - City:PISCATAWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:08854-8021
Mailing Address - Country:US
Mailing Address - Phone:908-331-6612
Mailing Address - Fax:
Practice Address - Street 1:303 GEORGE ST FL 2
Practice Address - Street 2:
Practice Address - City:NEW BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08901-2020
Practice Address - Country:US
Practice Address - Phone:800-969-5300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-22
Last Update Date:2023-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center