Provider Demographics
NPI:1427549302
Name:DAISY'S PLACE A SHELTER FOR WOMEN AND CHILDREN
Entity Type:Organization
Organization Name:DAISY'S PLACE A SHELTER FOR WOMEN AND CHILDREN
Other - Org Name:DAISYS PLACE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DIAMOND
Authorized Official - Middle Name:
Authorized Official - Last Name:BEACHUM
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LPC
Authorized Official - Phone:856-452-1322
Mailing Address - Street 1:227 LAUREL RD STE 200
Mailing Address - Street 2:
Mailing Address - City:VOORHEES
Mailing Address - State:NJ
Mailing Address - Zip Code:08043-8303
Mailing Address - Country:US
Mailing Address - Phone:856-452-1322
Mailing Address - Fax:
Practice Address - Street 1:227 LAUREL RD STE 200
Practice Address - Street 2:
Practice Address - City:VOORHEES
Practice Address - State:NJ
Practice Address - Zip Code:08043-8303
Practice Address - Country:US
Practice Address - Phone:856-452-1322
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-25
Last Update Date:2021-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health