Organization
FOUR WALLS THE 4WALLS LLC
Active
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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