Provider Demographics
NPI:1336217421
Name:GREATER TRENTON CMHC INC.
Entity Type:Organization
Organization Name:GREATER TRENTON CMHC INC.
Other - Org Name:GREATER TRENTON BEHAVIORAL HEALTHCARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:MONAHAN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:609-396-6788
Mailing Address - Street 1:PO BOX 1393
Mailing Address - Street 2:
Mailing Address - City:TRENTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08607-1393
Mailing Address - Country:US
Mailing Address - Phone:609-396-6788
Mailing Address - Fax:609-989-1245
Practice Address - Street 1:1001 SPRUCE ST
Practice Address - Street 2:SUITE 205
Practice Address - City:TRENTON
Practice Address - State:NJ
Practice Address - Zip Code:08638-3957
Practice Address - Country:US
Practice Address - Phone:609-396-6788
Practice Address - Fax:609-989-1245
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-30
Last Update Date:2014-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ103040909251B00000X
NJ103040105251S00000X
NJ103040603251S00000X
NJ103040104251S00000X
NJ103040704251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7610009Medicaid
NJ0047201Medicaid
NJ7495803Medicaid
NJ4549309Medicaid
NJ0019852Medicaid
NJ4549309Medicaid