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General NPI Number Information
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NPI Number | 1609680768
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Entity Type | Organization
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Legal Business Name | MARIGOLD CENTER FOR MENTAL HEALTH INC
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Dates
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Enumeration Date | 02/06/2025
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Last Update Date | 02/06/2025
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Provider Practice Location Address
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Address Line | 100 ASHURST LN STE 115
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City | MOUNT HOLLY
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State | NJ
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Zip | 08060-1202
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Country | US
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Telephone | 856-200-3141
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Fax |
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Provider Business Mailing Address
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Address Line | 1726 ROUTE 206
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City | SOUTHAMPTON
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State | NJ
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Zip | 08088-1425
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Country | US
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Telephone | 856-200-3141
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | AMANDA MITCHELL
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Credential | PMHNP-BC
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Telephone | 856-200-3141
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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