Portum Private Practice LLC
Portum Private Practice LLC is an Adolescent and Children Mental Health Clinic/Center in Annandale, New Jersey. Registered with an NPI since 2023.
- In the registry since
- 2023
What do these letters mean?
- LLC — Limited liability company
- A form of business registration, not a clinical qualification.
Practice location Address checks out
1465 Route 31 S Ste 11011102Annandale, NJ 08801-3129
Phone: (732) 614-0994
Show map & directions
Directions in Google Maps · Apple Maps · OpenStreetMap
Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Adolescent and Children Mental Health Clinic/Center (primary) | Taxonomy 261QM0855X |
|---|
Record details
| NPI number | 1255103388 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Jeffrey Decker — Chief Operating Officer · (732) 614-0994 |
| NPI enumerated | October 23, 2023 |
| Last updated in NPPES | October 23, 2023 |
| Certification date | October 23, 2023 |
| Mailing address | 1465 Route 31 S Ste 1101102, Annandale, NJ 08801-3129 |