Healthcare Provider Details
I. General information
NPI: 1720459977
Provider Name (Legal Business Name): PRICE SOCIAL SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/14/2015
Last Update Date: 06/01/2022
Certification Date: 06/01/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
102 BROWNING LN STE C3
CHERRY HILL NJ
08003-3195
US
IV. Provider business mailing address
130 TIFFANY LANE
WILLINGBORO NJ
08046
US
V. Phone/Fax
- Phone: 856-651-7904
- Fax: 856-229-7158
- Phone: 609-670-3674
- Fax: 609-877-0987
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 171M00000X |
| Taxonomy | Case Manager/Care Coordinator |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QD1600X |
| Taxonomy | Developmental Disabilities Clinic/Center |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 347C00000X |
| Taxonomy | Private Vehicle |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 373H00000X |
| Taxonomy | Day Training/Habilitation Specialist |
| License Number | |
| License Number State | |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 385HR2060X |
| Taxonomy | Child Intellectual and/or Developmental Disabilities Respite Care |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
AUNDREY
PRICE
Title or Position: EXECUTOR
Credential: B.S.
Phone: 609-670-3674