Healthcare Provider Details

I. General information

NPI: 1326483629
Provider Name (Legal Business Name): CENTERSTONE BEHAVIORAL HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/01/2013
Last Update Date: 05/01/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 LONGWOOD LN
VOORHEES NJ
08043-3928
US

IV. Provider business mailing address

10 LONGWOOD LN
VOORHEES NJ
08043-3928
US

V. Phone/Fax

Practice location:
  • Phone: 609-760-8910
  • Fax:
Mailing address:
  • Phone: 609-760-8910
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number25MA08317600
License Number StateNJ

VIII. Authorized Official

Name: DR. JOANNE MATHEWS
Title or Position: PRESIDENT
Credential: MD
Phone: 609-760-8910