Organization · NPI-2

Ketamine Care Mental Health Counseling LLC

Clinic/Center, Adult Mental Health · Fair Lawn, NJ

NPI number1093532608
StatusActive
Last updated in NPPESSep 24, 2024

Details

NPI
1093532608
Entity type
Organization (NPI-2)
Legal business name
Ketamine Care Mental Health Counseling LLC
Organization subpart
No
Enumeration date
Sep 24, 2024
Certification date
Sep 19, 2024
Last updated
Sep 24, 2024

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
261QM0850X Clinic/Center, Adult Mental Health––Yes

Other names

  • Katamine Care Counseling (Doing Business As)

Practice location

8-02 Plymouth Dr
Fair Lawn, NJ 07410-1641

Phone 718-687-7924

Mailing address

250 Pehle Ave Ste 200
Saddle Brook, NJ 07663-5835

Authorized official

Orly Bentata Goldenberg
Ceo
7186877924

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