Organization
DAVID STACKHOUSE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID RAY STACKHOUSE (PRESIDENT)
(973) 886-9701
Entity
Organization
Contact information
Practice address
101 MAIN ST, SPARTA, NJ 07871-1930
(973) 886-9701
(973) 729-4611
Mailing address
PO BOX 481, SPARTA, NJ 07871-0481
(973) 886-9701
(973) 729-4611
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
44SC00844700
NJ
Other
Enumeration date
10/05/2011
Last updated
10/17/2011
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