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General NPI Number Information
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NPI Number | 1871923490
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Entity Type | Organization
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Legal Business Name | AISOL CH LLC
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Dates
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Enumeration Date | 11/18/2013
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Last Update Date | 06/08/2024
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Provider Practice Location Address
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Address Line | 1930 MARLTON PIKE E BLDG T
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City | CHERRY HILL
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State | NJ
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Zip | 08003-2150
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Country | US
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Telephone | 856-336-5806
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Fax | 856-888-2137
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Provider Business Mailing Address
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Address Line | 1930 MARLTON PIKE E BLDG T
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City | CHERRY HILL
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State | NJ
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Zip | 08003-2150
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Country | US
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Telephone | 856-336-5806
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Fax | 856-888-2137
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | MICHAEL MADDALONI
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Credential |
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Telephone | 561-323-0049
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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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 | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number |
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License Number State |
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