Organization
SOUTH JERSEY BEHAVIORAL HEALTH RESOURCES INCORPORATED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THERESA C WILSON MSW LCSW (PRESIDENT/CEO)
(856) 361-1133
Entity
Organization
Contact information
Practice address
400 MARKET ST, 1ST FLOOR, CAMDEN, NJ 08102-1526
(856) 541-1700
(856) 541-1554
Mailing address
2500 MCCLELLAN AVE STE 300, PENNSAUKEN, NJ 08109-0001
(856) 361-1133
(856) 488-1450
Taxonomy
Speciality
Code
Description
License number
State
251T00000X
PACE Provider Organization
403010305
NJ
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
403010304
NJ
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
403010904
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0041106
—
NJ
05
—
0515752
—
NJ
01
—
403010304
DMHAS LICENSE
NJ
01
—
403010305
DMHS LICENSE
NJ
01
—
403010904
DMHAS LICENSE
NJ
01
—
406010904
DMHAS LICENSE
NJ
05
—
7477007
—
NJ
01
—
7677308
WORKFORCE NJ
NJ
Enumeration date
05/01/2007
Last updated
07/21/2022
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