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General NPI Number Information
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NPI Number | 1851803167
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Entity Type | Organization
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Legal Business Name | MGM COMMUNITY SERVICES INC
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Dates
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Enumeration Date | 10/26/2017
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Last Update Date | 10/29/2025
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Provider Practice Location Address
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Address Line | 1056 BECKLEY DR
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City | WILLIAMSTOWN
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State | NJ
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Zip | 08094-8808
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Country | US
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Telephone | 856-885-2120
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Fax | 856-885-2644
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Provider Business Mailing Address
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Address Line | 1056 BECKLEY DR
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City | WILLIAMSTOWN
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State | NJ
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Zip | 08094-8808
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Country | US
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Telephone | 856-885-2120
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Fax | 856-885-2644
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | KEMLEY WHITESIDE
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Credential |
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Telephone | 856-885-2120
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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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 | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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Taxonomy #3
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Taxonomy Code | 251X00000X
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Taxonomy Name | Supports Brokerage Agency
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License Number |
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Taxonomy #4
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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Taxonomy #5
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Taxonomy Code | 101YP1600X
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Taxonomy Name | Pastoral Counselor
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License Number |
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Taxonomy #6
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Taxonomy Code | 261QC1500X
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Taxonomy Name | Community Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 261QD1600X
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Taxonomy Name | Developmental Disabilities Clinic/Center
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License Number |
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License Number State |
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