Organization
FOUR WALLS THE 4WALLS LLC
Active
Other names
4WALLS
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JASON ALI BRICE SR. M.ED (EXECUTIVE DIRECTOR)
(856) 650-6556
Entity
Organization
Contact information
Practice address
2511 HAMILTON DR, VOORHEES, NJ 08043-2642
(856) 650-6556
Mailing address
PO BOX 201, SOMERDALE, NJ 08083-0201
(856) 650-6556
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
0400647708
NJ
Other
Enumeration date
03/27/2016
Last updated
03/27/2016
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