31D2273705 CLIA NUMBER - GARDEN STATE TREATMENT CENTER BH LLC

Laboratory Demographics

CLIA Number: 31D2273705

Facility Name: GARDEN STATE TREATMENT CENTER BH LLC

Facility Address:
350 SPARTA AVE STE A-201
SPARTA, NJ
ZIP 07871
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Facility Phone Number: 954 425-2949

Facility Type: Other - SUBSTANCE USE TREATMENT F

Certificate Type: Waiver

NPI Number: 1548751258

Taxonomy: 324500000X - Substance Abuse Rehabilitation Facility
A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances.

CLIA Record

Field Name	Field Value
CLIA Number	31D2273705
LAB Type	Other - SUBSTANCE USE TREATMENT F
Facility Name	GARDEN STATE TREATMENT CENTER BH LLC
Street	350 SPARTA AVE STE A-201
City	SPARTA
State	NJ
ZIP	07871
Phone	954 425-2949
CertificateType	4
CertificateEffectiveDate	12/19/2022
CertificateExpirationDate	12/18/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024