Organization
ATLANTICARE HEALTH SERVICES, INC.
Active
Other names
AtlantiCare Health Services - Mission Healthcare
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SANDY FESTA (EXECUTIVE DIRECTOR FQHC)
(609) 572-6051
Entity
Organization
Contact information
Practice address
2009 BACHARACH BLVD, ATLANTIC CITY, NJ 08401
(609) 344-5714
(609) 345-0775
Mailing address
65 W JIMMIE LEEDS RD, ATTN FINANCE J HOKE, POMONA, NJ 08205
(609) 569-7303
(609) 272-6251
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
23265
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0028592
—
NJ
01
—
31D103000
CMS-CLIA
NJ
01
—
60019117
HORIZON HEALTH HMO
NJ
Enumeration date
05/12/2006
Last updated
05/15/2018
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