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General NPI Number Information
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NPI Number | 1033413711
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Entity Type | Organization
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Legal Business Name | PARTNERSHIP FOR SUCCESSFUL LIVING INC
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Dates
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Enumeration Date | 01/10/2011
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Last Update Date | 01/10/2011
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Provider Practice Location Address
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Address Line | 221 LAUREL RD SUITE 300
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City | VOORHEES
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State | NJ
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Zip | 08043-2330
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Country | US
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Telephone | 856-482-6222
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Fax | 856-482-8568
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Provider Business Mailing Address
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Address Line | 221 LAUREL RD SUITE 300
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City | VOORHEES
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State | NJ
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Zip | 08043-2330
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Country | US
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Telephone | 856-482-6222
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Fax | 856-482-8568
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Authorized Official
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Title or Position | C.E.O.
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Name | MR. CHARLES BROWN
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Credential | LCSW
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Telephone | 856-482-6222
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 44SC05222600
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License Number State | NJ
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