| Glorious Dawn Mental Health Services Llc | |
|
540 North Ave Ste 3 Union NJ 07083-7149 | |
| (201) 470-6198 | |
| (201) 630-8916 |
| Full Name | Glorious Dawn Mental Health Services Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 540 North Ave Ste 3, Union, New Jersey |
| Authorized Official Name and Position | Lynda Uzonwanne (PMHNP) |
| Authorized Official Contact | 8622158536 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Glorious Dawn Mental Health Services Llc 540 North Ave Ste 3 Union NJ 07083-7149 Ph: (201) 470-6198 | Glorious Dawn Mental Health Services Llc 540 North Ave Ste 3 Union NJ 07083-7149 Ph: (201) 470-6198 |
| NPI Number | 1366197303 |
|---|---|
| Provider Enumeration Date | 02/17/2022 |
| Last Update Date | 06/06/2023 |
| Certification Date | 06/06/2023 |
| Medicare PECOS PAC ID | 5698160711 |
|---|---|
| Medicare Enrollment ID | O20220328000352 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366197303 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Lynda N Uzonwanne |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851968515 PECOS PAC ID: 5799174462 Enrollment ID: I20211118001118 |
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