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General NPI Number Information
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NPI Number | 1427940378
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Entity Type | Organization
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Legal Business Name | MARYVILLE, INC.
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Dates
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Enumeration Date | 07/16/2025
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Last Update Date | 07/16/2025
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Provider Practice Location Address
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Address Line | 526 S BURNT MILL RD
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City | VOORHEES
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State | NJ
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Zip | 08043-2205
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Country | US
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Telephone | 856-227-2717
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Fax |
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Provider Business Mailing Address
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Address Line | 526 S BURNT MILL RD
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City | VOORHEES
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State | NJ
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Zip | 08043-2205
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Country | US
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Telephone | 856-227-2717
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Fax |
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Authorized Official
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Title or Position | COO
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Name | JARED LEVY
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Credential |
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Telephone | 856-227-2717
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number |
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License Number State |
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