Southgate Residential Life Center

LBN: Southgate Residential Life Center
Southgate Residential Life Center is an health care organization with primary practice located at 2630 Route 206 , Mount Holly NJ 08060-6708. The organization recently has only one registered license in Residential Treatment Facilities / Residential Treatment Facility, Emotionally Disturbed Children, which is considered as the primary health care specialty. Southgate Residential Life Center can be contacted via phone (609) 288-6398, or through Davis, Lawrence via phone (609) 288-6398.

Contact Information

Primary practice address
2630 Route 206 Mount Holly NJ 08060-6708
Phone: (609) 288-6398
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Davis, Lawrence
Phone: (609) 288-6398

Health care specialties

SpecialtyCodeLicense #State
Residential Treatment Facilities / Residential Treatment Facility, Emotionally Disturbed Children 322D00000X

Profile Details

NPI number 1699002865
LBN Legal business name Southgate Residential Life Center
DBA Doing business as
Authorized official Davis, Lawrence
Entity Organization
Organization subpart 1 No
Enumeration date Nov 10th, 2009
Last updated Nov 10th, 2009 - about 15 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1699002865 NPPES
New Jersey Other 1700049475 INDIVIDUAL
New Jersey MEDICAID 1946510 INDIVIDUAL

Popular Providers