NPI 1699002865

Southgate Residential Life Center

Organisation Emotionally Disturbed Childrens' Residential Treatment Facility Mount Holly, NJ

Practice location

Address: 2630 Route 206, Mount Holly, NJ 08060-6708
Phone: (609) 288-6398

Authorised official

Name: Lawrence Davis
Title: Member
Phone: (609) 288-6398

Registered specialties

Emotionally Disturbed Childrens' Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 322D00000X

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Registry record

NPI: 1699002865
Entity type: Organization
NPI issued: 10 Nov 2009
Record last updated: 10 Nov 2009

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.