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Portum Private Practice Llc
Adolescent and Children Mental Health Clinic/Center in Annandale, New Jersey
NPI 1255103388

Portum Private Practice Llc is an Adolescent and Children Mental Health Clinic/Center based in Annandale, NJ and is specialized in Adolescent and Children Mental Health. Portum Private Practice Llc practices in Annandale, NJ. The NPI Number for Portum Private Practice Llc is 1255103388 and holds a License No. (New Jersey).

The current practice location address for Portum Private Practice Llc is 1465 Route 31 S Ste 11011102, Annandale, NJ and can be reached out via phone at 732-614-0994.

Location: 1465 Route 31 S Ste 11011102, Annandale, NJ, 08801-3129
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1255103388
Provider Name
Portum Private Practice Llc
Credential
Provider Entity Type
Organization
Address
1465 Route 31 S Ste 11011102, Annandale, NJ, 08801-3129
Phone Number
732-614-0994
Fax Number
Provider Enumeration Date
10/23/2023
Last Update Date
03/13/2024
institution
Provider Business Practice Location Address Details
Address
1465 Route 31 S Ste 11011102
City
Annandale
State
New Jersey
Zip
08801-3129
Phone Number
732-614-0994
Fax Number
person
Provider Business Mailing Address Details
Address
1465 Route 31 S Ste 11011102
City
Annandale
State
New Jersey
Zip
08801-3129
Phone Number
732-614-0994
Fax Number
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Adolescent and Children Mental Health
Taxonomy
261QM0855X
License No.
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Definition
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in children and adolescents. Services may be provided to parents and family members of the patient in the form of conjoint, group, or individual therapy, and education and/or training.
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