Individual
CASEY MOSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
610 PEMBERTON BROWNS MILLS RD, PEMBERTON, NJ 08068-1537
(609) 519-1816
(609) 283-0262
Mailing address
610 PEMBERTON BROWNS MILLS RD, PEMBERTON, NJ 08068-1537
(609) 519-1816
(609) 283-0262
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
1000140
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1000140
SUBSTANCE ABUSE REHABILITATION FACILITY
NJ
Enumeration date
01/20/2023
Last updated
01/20/2023
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