Healthcare Provider Details

I. General information

NPI: 1124405790
Provider Name (Legal Business Name): TWIN OAKS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/02/2015
Last Update Date: 05/02/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2201 CHAPEL AVE W
CHERRY HILL NJ
08002-2048
US

IV. Provider business mailing address

2201 CHAPEL AVE W
CHERRY HILL NJ
08002-2048
US

V. Phone/Fax

Practice location:
  • Phone: 856-428-4357
  • Fax:
Mailing address:
  • Phone: 856-428-4357
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code273R00000X
TaxonomyPsychiatric Hospital Unit
License Number
License Number State

VIII. Authorized Official

Name: PATRICIA GRAU
Title or Position: CRISIS INTERVENTION SPECIALIST
Credential:
Phone: 856-870-8265