Organization
THE 4WALLS FOUNDATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JASON A BRICE SR. M.ED, L.A.C. (MEMBER)
(856) 650-6556
Entity
Organization
Contact information
Practice address
2511 HAMILTON DR, VOORHEES, NJ 08043-2642
(856) 650-6556
Mailing address
2511 HAMILTON DR, VOORHEES, NJ 08043-2642
(856) 650-6556
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
0450137733
NJ
Other
Enumeration date
02/16/2017
Last updated
02/16/2017
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