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Organization

STABLE COMMUNITY SERVICES

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. STACEY WALLER (EXECUTIVE DIRECTO)
(609) 386-0650
Entity
Organization

Contact information

Practice address
116 W BROAD ST, BURLINGTON CITY, NJ 08016-1410
(609) 386-0650
(609) 386-0652
Mailing address
116 W BROAD ST, BURLINGTON CITY, NJ 08016-1410

Taxonomy

Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
2000599
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0401056
NJ
05
0473723
NJ
Enumeration date
02/23/2016
Last updated
02/23/2016
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