MEDICARE: STABLE COMMUNITY SERVICES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency		NJ

General Provider Information

NPI Number	:	1568885663
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STABLE COMMUNITY SERVICES

Provider Business Mailing Address
First Line	:	513 HIGH ST
Second Line	:
City	:	BURLINGTON CITY
State	:	NJ
Zip	:	08016-4503
Country	:	US
Telephone Number	:	609-386-0650
Fax Number	:	609-386-0652

Provider Business Practice Location Address
First Line	:	513 HIGH ST
Second Line	:
City	:	BURLINGTON CITY
State	:	NJ
Zip	:	08016-4503
Country	:	US
Telephone Number	:	609-386-0650
Fax Number	:	609-386-0652

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	STACEY DELAINE WALLER
Credential	:	LCSW
Telephone Number	:	609-386-0650

Provider Enumeration Date	:	01/24/2014
Last Update Date	:	06/17/2022

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Directions to “STABLE COMMUNITY SERVICES ” Practice Location

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