| Ruby Road Llc | |
|
178 N Broadway Pennsville NJ 08070-1422 | |
| (856) 887-1422 | |
| Not Available |
| Full Name | Ruby Road Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 178 N Broadway, Pennsville, New Jersey |
| Authorized Official Name and Position | Susan R White (OWNER/ THERAPIST) |
| Authorized Official Contact | 8568871422 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ruby Road Llc 178 N Broadway Pennsville NJ 08070-1422 Ph: () - | Ruby Road Llc 178 N Broadway Pennsville NJ 08070-1422 Ph: (856) 887-1422 |
| NPI Number | 1922516913 |
|---|---|
| Provider Enumeration Date | 01/12/2018 |
| Last Update Date | 01/12/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922516913 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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