Provider Demographics
NPI:1053574368
Name:PRINCETON HOUSE BEHAVIORAL HEALTH
Entity type:Organization
Organization Name:PRINCETON HOUSE BEHAVIORAL HEALTH
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CLINICAL COORDINATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:
Authorized Official - Last Name:LOPRESTI
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:856-779-2300
Mailing Address - Street 1:375 N KINGS HWY
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08034-1013
Mailing Address - Country:US
Mailing Address - Phone:856-779-2300
Mailing Address - Fax:856-779-2988
Practice Address - Street 1:375 NORTH KINGS HIGHWAY
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08034-1013
Practice Address - Country:US
Practice Address - Phone:856-779-2300
Practice Address - Fax:856-779-2988
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PRINCETON HEALTH CARE SYSTEM
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-07-07
Last Update Date:2008-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ931740303273R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273R00000XHospital UnitsPsychiatric Unit