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NPI Provider: 1003812728
Contact Name: Bonforte J Richard
Position: President
Phone: (201) 714-7903
Liberty Child And Adolescent Health Services Information:
Liberty Child And Adolescent Health Services organization have npi 1003812728, taxonomy code is 174400000X with license number is K3745 in . This Business address located in PO Box 334, Wayne, NJ 74740 New Jersey. Get directions of Liberty Child And Adolescent Health Services.
Practice Location
Address: 550 Newark Ave, Jersey City, NJ 73061
Phone: (201) 714-7902
Business Location
Address: PO Box 334, Wayne, NJ 74740
Phone: (201) 804-2800
Fax: (512) 795-5122
Taxonomy
Taxonomy Code: 174400000X
License Number: K3745
License Number of State: TX
Primary Taxonomy Switch: Y
Enumeration Date: 6/27/2005
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