Imago Dei Behavioral Health Incorporated

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

IMAGO DEI BEHAVIORAL HEALTH INCORPORATED

Practice address

1014 Birch St
Boonton, NJ 07005-1404

Phone

(973) 874-6326

NPI assigned

Mar 8, 2024

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. John D. Testa

Title

Chief Financial Officer

Phone

(201) 452-9082

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1709856000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709856000000",
    "number": "1679331227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1014 BIRCH ST",
            "city": "BOONTON",
            "state": "NJ",
            "postal_code": "070051404",
            "telephone_number": "973-874-6326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1014 BIRCH ST",
            "city": "BOONTON",
            "state": "NJ",
            "postal_code": "070051404",
            "telephone_number": "973-874-6326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMAGO DEI BEHAVIORAL HEALTH INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-08",
        "last_updated": "2024-03-08",
        "certification_date": "2024-03-08",
        "status": "A",
        "authorized_official_last_name": "TESTA",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "201-452-9082",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hennessy Medical Professional Corporation (Boonton Foot and Ankle)
• Brett Kevin Hodshon, DC
• Linda Jean Hogoboom, MS, OTR/L
• Rebecca J Horan, LCSW
• Gabrielle Huresky
• Iraj Nejat, M.D. ,F.a.a.P.,P.a.
• Francis A Jadeszko III, PTA
• Ali Hasan Jafary, MD
• Suman Lata Jalan, M.D.
• Jea Ava Maria LLC (Main Pharmacy)

• Community/Behavioral Health Agency in Boonton, NJ
• Providers in Boonton, NJ by specialty
• Community/Behavioral Health Agency in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.