Provider Demographics
NPI:1639670755
Name:THE SOUTHWEST COUNCIL, INC.
Entity Type:Organization
Organization Name:THE SOUTHWEST COUNCIL, INC.
Other - Org Name:NCADD OF SOUTHWEST JERSEY, INC.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:M
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:LCADC, CPS, CCS, LPC
Authorized Official - Phone:856-794-1011
Mailing Address - Street 1:1405 N DELSEA DR
Mailing Address - Street 2:
Mailing Address - City:VINELAND
Mailing Address - State:NJ
Mailing Address - Zip Code:08360-2291
Mailing Address - Country:US
Mailing Address - Phone:856-794-1011
Mailing Address - Fax:856-794-1011
Practice Address - Street 1:1405 N DELSEA DR
Practice Address - Street 2:
Practice Address - City:VINELAND
Practice Address - State:NJ
Practice Address - Zip Code:08360-2291
Practice Address - Country:US
Practice Address - Phone:856-794-1011
Practice Address - Fax:856-794-1011
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-23
Last Update Date:2019-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ2000656251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health