Organization
HENDRICKS HOUSE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. AUDREY CARTER MSM, LCADC (EXECUTIVE DIRECTOR)
(856) 794-2443
Entity
Organization
Contact information
Practice address
542 N WEST BLVD, VINELAND, NJ 08360-2847
(856) 794-2443
(856) 205-9277
Mailing address
542 N. WEST BLVD, VINELAND, NJ 08360
(856) 794-2443
(856) 794-8887
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
1000007-07
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
005515
—
NJ
05
—
7609507
—
NJ
Enumeration date
05/22/2007
Last updated
08/05/2014
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