Organization
MARYVILLE, INC
Active
Other names
MARYVILLE ADDICTION TREATMENT CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JARED LEVY (CFO)
(856) 863-3913
Entity
Organization
Contact information
Practice address
1903 GRANT AVE, WILLIAMSTOWN, NJ 08094
(856) 629-0244
(856) 629-3760
Mailing address
129 JOHNSON RD STE 7, TURNERSVILLE, NJ 08012-1777
(856) 863-3913
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
1000028
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0431753
—
NJ
Enumeration date
10/02/2017
Last updated
08/01/2018
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