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Organization

MARYVILLE, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. JARED LEVY (CFO)
(856) 863-3913
Entity
Organization

Contact information

Practice address
1903 GRANT AVE, WILLIAMSTOWN, NJ 08094
(856) 629-0244
(856) 629-0799
Mailing address
1903 GRANT AVE, WILLIAMSTOWN, NJ 08094-6139
(856) 629-0244
(856) 629-0799

Taxonomy

Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
80850
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7602804
NJ
Enumeration date
05/03/2007
Last updated
08/01/2018
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