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Organization
MY FATHER'S HOUSE, INC
Active
Organization
MY FATHER'S HOUSE, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MIRIAM BRODERICK LCADC, CCS (CEO)
(856) 742-0900
Entity
Organization
Contact information
Practice address
104 N KING ST, GLOUCESTER CITY, NJ 08030-1417
(856) 742-0900
(856) 742-0811
Mailing address
PO BOX 230, GLOUCESTER CITY, NJ 08030-0230
(856) 742-0900
(856) 742-0811
Taxonomy
Speciality
Code
Description
License number
State
261QR0400X
Rehabilitation Clinic/Center
Primary
—
NULL
Other
Enumeration date
06/05/2007
Last updated
08/01/2016
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