Organization
SOUTH JERSEY BEHAVIORAL HEALTH RESOURCES INCORPORATED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. THERESA WISLON C WILSON LCSW (PRESIDENT/ CEO)
(856) 361-1120
Entity
Organization
Contact information
Practice address
53 HADDONFIELD RD STE 316, CHERRY HILL, NJ 08002-4802
(856) 361-2710
(856) 346-3627
Mailing address
2500 MCCLELLAN AVE STE 300, PENNSAUKEN, NJ 08109-0001
(856) 361-1100
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
403010904
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0515752
—
NJ
01
—
403010904
NJ DMHAS
NJ
Enumeration date
07/13/2017
Last updated
07/13/2017
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