Healthcare Provider Details

I. General information

NPI: 1891938023
Provider Name (Legal Business Name): THE FOUNDATION FOR FAMILY GUIDANCE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/17/2009
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

525 ROUTE 73 N STE 104
MARLTON NJ
08053-3422
US

IV. Provider business mailing address

1871 ROUTE 70 E SUITE 202
CHERRY HILL NJ
08003-2020
US

V. Phone/Fax

Practice location:
  • Phone: 606-509-9497
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number37PC00597900
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number37PC00597900
License Number StateNJ

VIII. Authorized Official

Name: NANCY P GEARHART
Title or Position: PRESIDENT AND CEO
Credential: PH.D.
Phone: 856-751-8700