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General NPI Number Information
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NPI Number | 1639670755
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Entity Type | Organization
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Legal Business Name | THE SOUTHWEST COUNCIL, INC.
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Dates
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Enumeration Date | 02/23/2018
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Last Update Date | 03/10/2019
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Provider Practice Location Address
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Address Line | 1405 N DELSEA DR
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City | VINELAND
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State | NJ
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Zip | 08360-2291
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Country | US
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Telephone | 856-794-1011
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Fax | 856-794-1011
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Provider Business Mailing Address
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Address Line | 1405 N DELSEA DR
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City | VINELAND
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State | NJ
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Zip | 08360-2291
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Country | US
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Telephone | 856-794-1011
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Fax | 856-794-1011
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | JOSEPH M. WILLIAMS
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Credential | LCADC, CPS, CCS, LPC
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Telephone | 856-794-1011
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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 | 2000656
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License Number State | NJ
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