Organization
BY STEPHANIE A
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHANIE MOORE (CEO)
(856) 275-3061
Entity
Organization
Contact information
Practice address
77 TAILOR LN, SICKLERVILLE, NJ 08081-5697
(856) 275-3061
Mailing address
77 TAILOR LN, SICKLERVILLE, NJ 08081-5697
(856) 275-3061
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
10/04/2021
Last updated
10/04/2021
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