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General NPI Number Information
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NPI Number | 1780262477
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Entity Type | Organization
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Legal Business Name | THREE RIVERS SERVICES
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Dates
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Enumeration Date | 04/01/2021
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Last Update Date | 06/17/2021
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Provider Practice Location Address
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Address Line | 198 CEDAR AVE
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City | TUCKERTON
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State | NJ
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Zip | 08087-1407
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Country | US
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Telephone | 609-857-3705
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Fax |
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Provider Business Mailing Address
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Address Line | 198 CEDAR AVE
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City | TUCKERTON
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State | NJ
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Zip | 08087-1407
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Country | US
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Telephone | 609-857-3705
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DAVID R JULIAN
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Credential |
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Telephone | 609-857-3705
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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