Organization
MGM COMMUNITY SERVICES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEMLEY WHITESIDE (EXECUTIVE DIRECTOR)
(856) 885-2120
Entity
Organization
Contact information
Practice address
1056 BECKLEY DR, WILLIAMSTOWN, NJ 08094-8808
(856) 885-2120
(856) 885-2644
Mailing address
1056 BECKLEY DR, WILLIAMSTOWN, NJ 08094-8808
(856) 885-2120
(856) 885-2644
Taxonomy
Speciality
Code
Description
License number
State
101YP1600X
Pastoral Counselor
—
—
251E00000X
Home Health Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
251X00000X
Supports Brokerage Agency
—
—
253Z00000X
In Home Supportive Care Agency
—
—
261QC1500X
Community Health Clinic/Center
—
—
261QD1600X
Developmental Disabilities Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0595985
—
NJ
Enumeration date
10/26/2017
Last updated
10/29/2025
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