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General NPI Number Information
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NPI Number | 1245352905
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Entity Type | Organization
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Legal Business Name | PROMISE ALTERNATIVE CARE INC
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Dates
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Enumeration Date | 04/04/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1149 MARLKRESS RD
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City | CHERRY HILL
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State | NJ
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Zip | 08003-2317
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Country | US
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Telephone | 856-751-4884
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Fax | 856-751-7146
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Provider Business Mailing Address
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Address Line | 146 BLACK HORSE PIKE
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City | MOUNT EPHRAIM
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State | NJ
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Zip | 08059-2007
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Country | US
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Telephone | 856-456-1121
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Fax | 856-456-1076
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Authorized Official
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Title or Position | FINANCIAL ADMINISTRATOR
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Name | MR. STEPHEN P CONSIDINE
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Credential |
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Telephone | 856-456-1121
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number | 080472
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License Number State | NJ
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