Stable Community Services | |
513 High St Burlington City NJ 08016-4503 | |
(609) 386-0650 | |
(609) 386-0652 |
Full Name | Stable Community Services |
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Speciality | Community/Behavioral Health |
Location | 513 High St, Burlington City, New Jersey |
Authorized Official Name and Position | Stacey Delaine Waller (EXECUTIVE DIRECTOR) |
Authorized Official Contact | 6093860650 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Stable Community Services 513 High St Burlington City NJ 08016-4503 Ph: (609) 386-0650 | Stable Community Services 513 High St Burlington City NJ 08016-4503 Ph: (609) 386-0650 |
NPI Number | 1568885663 |
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Provider Enumeration Date | 01/24/2014 |
Last Update Date | 06/17/2022 |
Certification Date | 06/17/2022 |
Medicare PECOS PAC ID | 9436374022 |
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Medicare Enrollment ID | O20140716000781 |
Identifier | Type | State | Issuer |
---|---|---|---|
1568885663 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
251S00000X | Community/behavioral Health | (New Jersey) | Primary |
Provider Name | Glenn Wojtowicz |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1770634545 PECOS PAC ID: 1456442425 Enrollment ID: I20070806000143 |
Provider Name | Eva Sleczka |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1124252309 PECOS PAC ID: 4789738188 Enrollment ID: I20090819000837 |
Provider Name | Agiliga A Muomah |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1841662566 PECOS PAC ID: 3274824677 Enrollment ID: I20160615000314 |
Provider Name | Omotayo Elizabeth Awujoola |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1194932392 PECOS PAC ID: 8426333774 Enrollment ID: I20170328002804 |
Provider Name | Claudia M Teh |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1366992554 PECOS PAC ID: 2062799158 Enrollment ID: I20170427000123 |
Provider Name | Dana M Lee |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1538576665 PECOS PAC ID: 2264777069 Enrollment ID: I20181226001318 |
Provider Name | Shanae S Caldwell Cole |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1891355657 PECOS PAC ID: 4385077643 Enrollment ID: I20191127002448 |
Provider Name | Alice L Kalu |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1245870658 PECOS PAC ID: 3870929698 Enrollment ID: I20200213002663 |
Provider Name | Ashley Anderson |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1124663679 PECOS PAC ID: 6002238474 Enrollment ID: I20200612002282 |
Provider Name | Robyera Revoal |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1194104844 PECOS PAC ID: 3274937693 Enrollment ID: I20210807000021 |
Provider Name | Esther Chidinma Onwu |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1063087385 PECOS PAC ID: 7416354410 Enrollment ID: I20210917000790 |
Provider Name | Stacey D Waller |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1730581349 PECOS PAC ID: 6709002330 Enrollment ID: I20220502001206 |
Provider Name | Fausat F Odubiyi |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1881174654 PECOS PAC ID: 0749603496 Enrollment ID: I20220512000298 |