Provider Demographics
NPI:1326557356
Name:CUMBERLAND COUNTY GUIDANCE CENTER
Entity Type:Organization
Organization Name:CUMBERLAND COUNTY GUIDANCE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:NATALIE
Authorized Official - Middle Name:
Authorized Official - Last Name:DUPNOCK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-825-6810
Mailing Address - Street 1:2038 CARMEL RD
Mailing Address - Street 2:
Mailing Address - City:MILLVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08332-9754
Mailing Address - Country:US
Mailing Address - Phone:856-825-6810
Mailing Address - Fax:
Practice Address - Street 1:2038 CARMEL RD
Practice Address - Street 2:
Practice Address - City:MILLVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08332-9754
Practice Address - Country:US
Practice Address - Phone:856-825-6810
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0036706Medicaid