Provider Demographics
NPI:1093856387
Name:CUMBERLAND COUNTY GUIDANCE CENTER
Entity type:Organization
Organization Name:CUMBERLAND COUNTY GUIDANCE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OUTPATIENT CASE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CATHY
Authorized Official - Middle Name:JEANETTE
Authorized Official - Last Name:SOUDERS
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:856-825-6810
Mailing Address - Street 1:2038 CARMEL RD
Mailing Address - Street 2:
Mailing Address - City:MILLVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08332
Mailing Address - Country:US
Mailing Address - Phone:856-825-6810
Mailing Address - Fax:856-765-0252
Practice Address - Street 1:510 OPAL RD
Practice Address - Street 2:
Practice Address - City:MILLVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08332-9754
Practice Address - Country:US
Practice Address - Phone:856-825-6810
Practice Address - Fax:856-765-0252
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NP04411400251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health