Healthcare Provider Details

I. General information

NPI: 1154813392
Provider Name (Legal Business Name): THERAPEUTIC LEARNING CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2018
Last Update Date: 06/04/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24 GLENOLDEN LN
WILLINGBORO NJ
08046-3212
US

IV. Provider business mailing address

24 GLENOLDEN LN
WILLINGBORO NJ
08046-3212
US

V. Phone/Fax

Practice location:
  • Phone: 609-877-4111
  • Fax: 609-877-5551
Mailing address:
  • Phone: 609-877-4111
  • Fax: 609-877-5551

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: DR. STEVEN ALAN MORSE
Title or Position: EXECUTIVE DIRECTOR
Credential: ED.D.
Phone: 609-877-4111