Provider Demographics
NPI:1568885663
Name:STABLE COMMUNITY SERVICES
Entity Type:Organization
Organization Name:STABLE COMMUNITY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:STACEY
Authorized Official - Middle Name:DELAINE
Authorized Official - Last Name:WALLER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:609-386-0650
Mailing Address - Street 1:513 HIGH ST
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:08016-4503
Mailing Address - Country:US
Mailing Address - Phone:609-386-0650
Mailing Address - Fax:609-386-0652
Practice Address - Street 1:513 HIGH ST
Practice Address - Street 2:
Practice Address - City:BURLINGTON CITY
Practice Address - State:NJ
Practice Address - Zip Code:08016-4503
Practice Address - Country:US
Practice Address - Phone:609-386-0650
Practice Address - Fax:609-386-0652
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-24
Last Update Date:2022-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health