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General NPI Number Information
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NPI Number | 1134536071
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Entity Type | Organization
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Legal Business Name | SANDY SHORE FAMILY CONSELING
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Dates
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Enumeration Date | 07/11/2014
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Last Update Date | 07/11/2014
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Provider Practice Location Address
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Address Line | 415 NEW RD
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City | SOMERS POINT
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State | NJ
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Zip | 08244-2143
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Country | US
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Telephone | 609-224-9572
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Fax | 609-653-3042
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Provider Business Mailing Address
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Address Line | 408 S GIBBS ST
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City | CAPE MAY COURT HOUSE
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State | NJ
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Zip | 08210-3223
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | BRENNA CASH
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Credential |
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Telephone | 609-224-9572
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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 | 37PC00468100
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License Number State | NJ
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