Healthcare Provider Details

I. General information

NPI: 1033242326
Provider Name (Legal Business Name): HISPANIC FAMILY CENTER OF SOUTHERN NEW JERSEY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/14/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35 CHURCH ST
CAMDEN NJ
08105-2413
US

IV. Provider business mailing address

35 CHURCH ST
CAMDEN NJ
08105-2413
US

V. Phone/Fax

Practice location:
  • Phone: 856-541-6985
  • Fax: 856-963-2663
Mailing address:
  • Phone: 856-541-6985
  • Fax: 856-963-2663

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number StateNJ

VIII. Authorized Official

Name: MS. ELSA CANDELARIO
Title or Position: EXECUTIVE DIRECTOR
Credential: MSW, LCSW
Phone: 856-541-6985