Provider Demographics
NPI:1720737745
Name:ADVANCED BEHAVIORAL HEALTH SERVICES, LLC
Entity Type:Organization
Organization Name:ADVANCED BEHAVIORAL HEALTH SERVICES, LLC
Other - Org Name:ADVANCED BEHAVIORAL HEALTH SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:THERAPIST, CEO
Authorized Official - Prefix:
Authorized Official - First Name:LALI
Authorized Official - Middle Name:
Authorized Official - Last Name:BINDER
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:856-625-9194
Mailing Address - Street 1:PO BOX 236
Mailing Address - Street 2:
Mailing Address - City:WENONAH
Mailing Address - State:NJ
Mailing Address - Zip Code:08090-0236
Mailing Address - Country:US
Mailing Address - Phone:856-625-9194
Mailing Address - Fax:856-644-4599
Practice Address - Street 1:591 MANTUA BLVD STE 201
Practice Address - Street 2:
Practice Address - City:SEWELL
Practice Address - State:NJ
Practice Address - Zip Code:08080-1032
Practice Address - Country:US
Practice Address - Phone:856-625-9194
Practice Address - Fax:856-644-4599
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-18
Last Update Date:2022-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)