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General NPI Number Information
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NPI Number | 1922628502
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Entity Type | Organization
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Legal Business Name | SEABROOK HOUSE, INC.
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Dates
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Enumeration Date | 04/23/2020
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Last Update Date | 04/23/2020
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Provider Practice Location Address
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Address Line | 101 MADISON AVE STE 205
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City | MORRISTOWN
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State | NJ
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Zip | 07960-7305
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Country | US
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Telephone | 973-946-8200
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Fax | 973-795-2229
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Provider Business Mailing Address
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Address Line | 133 POLK LN
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City | BRIDGETON
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State | NJ
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Zip | 08302-5905
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Country | US
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Telephone | 856-455-7575
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Fax |
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Authorized Official
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Title or Position | QUALITY MANAGER
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Name | MRS. CRYSTAL REBECCA SMITH
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Credential |
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Telephone | 856-455-7575
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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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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