Organization
WAY OF THE SPIRIT COUNSELING SERVICES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACQUELINE P COOKE M.D. (MEDICAL DIRECTOR)
(856) 963-0500
Entity
Organization
Contact information
Practice address
2600 MOUNT EPHRAIM AVE, SUITE 405, CAMDEN, NJ 08104-3236
(856) 963-7323
(856) 963-7324
Mailing address
1116 N 19TH STREET, SUITE B, CAMDEN, NJ 08105
(856) 963-7323
(856) 963-7324
Taxonomy
Speciality
Code
Description
License number
State
261QR0401X
Comprehensive Outpatient Rehabilitation Facility (CORF)
—
NJ
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0492043LR
—
NJ
Enumeration date
09/11/2015
Last updated
05/16/2018
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