Provider Demographics
NPI:1184353856
Name:T & K BAFFOUR PSYCHIATRIC RECOVERY CENTER
Entity type:Organization
Organization Name:T & K BAFFOUR PSYCHIATRIC RECOVERY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:THERESA
Authorized Official - Middle Name:A
Authorized Official - Last Name:BAFFOUR
Authorized Official - Suffix:
Authorized Official - Credentials:DNP
Authorized Official - Phone:908-337-1199
Mailing Address - Street 1:PO BOX 203
Mailing Address - Street 2:
Mailing Address - City:PHILLIPSBURG
Mailing Address - State:NJ
Mailing Address - Zip Code:08865-0203
Mailing Address - Country:US
Mailing Address - Phone:484-544-2703
Mailing Address - Fax:
Practice Address - Street 1:445 MARSHALL ST STE 148B
Practice Address - Street 2:
Practice Address - City:PHILLIPSBURG
Practice Address - State:NJ
Practice Address - Zip Code:08865-2695
Practice Address - Country:US
Practice Address - Phone:484-544-2703
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-08
Last Update Date:2022-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty