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General NPI Number Information
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NPI Number | 1831637354
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Entity Type | Organization
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Legal Business Name | GENERATIONS INC.
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Dates
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Enumeration Date | 02/03/2017
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Last Update Date | 07/29/2017
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Provider Practice Location Address
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Address Line | 113 WHITE HORSE RD W STE 5&6
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City | VOORHEES
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State | NJ
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Zip | 08043-3672
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Country | US
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Telephone | 856-441-4004
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Fax | 856-435-1090
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Provider Business Mailing Address
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Address Line | 10 FOSTER AVE STE 1A
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City | GIBBSBORO
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State | NJ
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Zip | 08026-1162
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Country | US
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Telephone | 856-782-6776
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Fax | 856-435-1090
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Authorized Official
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Title or Position | DIRECTOR
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Name | MRS. BRENDA BEDWARD
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Credential | LCSW,LCADC
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Telephone | 856-441-4004
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 | 2000019-05
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License Number State | NJ
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