Organization
RUBY ROAD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN R WHITE LPC (OWNER/ THERAPIST)
(856) 887-1422
Entity
Organization
Contact information
Practice address
178 N BROADWAY, PENNSVILLE, NJ 08070-1422
(856) 887-1422
Mailing address
178 N BROADWAY, PENNSVILLE, NJ 08070-1422
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
01/12/2018
Last updated
01/12/2018
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