| Non Profit Organization | |
|
101 Rt 130 S Grant Building Suite 440 Cinnaminson NJ 08077-2845 | |
| (856) 829-9440 | |
| Not Available |
| Full Name | Non Profit Organization |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 101 Rt 130 S, Cinnaminson, New Jersey |
| Authorized Official Name and Position | Momah G Cooper (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 8568299440 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Non Profit Organization 101 Rt 130 S Grant Building Suite 440 Cinnaminson NJ 08077-2845 Ph: (856) 829-9440 | Non Profit Organization 101 Rt 130 S Grant Building Suite 440 Cinnaminson NJ 08077-2845 Ph: (856) 829-9440 |
| NPI Number | 1669663746 |
|---|---|
| Provider Enumeration Date | 08/05/2007 |
| Last Update Date | 08/05/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669663746 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | PC003757 (Pennsylvania) | Secondary |
| 1041C0700X | Social Worker - Clinical | 445L05145400 (New Jersey) | Primary |
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