Provider Demographics
NPI:1003327958
Name:SPRING BEHAVIORAL HEALTH OF NEW JERSEY LLC
Entity Type:Organization
Organization Name:SPRING BEHAVIORAL HEALTH OF NEW JERSEY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:STACY
Authorized Official - Middle Name:
Authorized Official - Last Name:CLOYD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-605-4986
Mailing Address - Street 1:1489 BALTIMORE PIKE STE 250
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:PA
Mailing Address - Zip Code:19064-3974
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:409 ROUTE 70 E STE 2
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08034-2413
Practice Address - Country:US
Practice Address - Phone:610-544-2110
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-18
Last Update Date:2023-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty