Organization
GARDEN STATE BEHAVIOAR HEALTH SERVICES SOUTH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN B HUDOME DCH (PARTNER)
(856) 797-8777
Entity
Organization
Contact information
Practice address
2 EVES DR, SUITE 104, MARLTON, NJ 08053-3193
(856) 797-8777
(856) 797-6764
Mailing address
2 EVES DR, SUITE 104, MARLTON, NJ 08053-3193
(856) 797-8777
(856) 797-6764
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
07/25/2007
Last updated
07/25/2007
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