Healthcare Provider Details

I. General information

NPI: 1518445881
Provider Name (Legal Business Name): HOUSE OF REFUGE FOR WOMEN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2018
Last Update Date: 05/15/2025
Certification Date: 05/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23 HARVEST LN
SICKLERVILLE NJ
08081-3059
US

IV. Provider business mailing address

23 HARVEST LN
SICKLERVILLE NJ
08081-3059
US

V. Phone/Fax

Practice location:
  • Phone: 856-397-8022
  • Fax:
Mailing address:
  • Phone: 856-397-8022
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: MS. SHERI DURRICKS
Title or Position: CEO
Credential: LCADC LPC MHSC
Phone: 856-397-8022