Provider Demographics
NPI:1962818112
Name:CAPE MAY COUNTY COUNCIL ON ALCOHOLISM AND DRUG ABUSE, INC.
Entity Type:Organization
Organization Name:CAPE MAY COUNTY COUNCIL ON ALCOHOLISM AND DRUG ABUSE, INC.
Other - Org Name:CAPE ASSIST
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JOANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:LITTLE
Authorized Official - Suffix:
Authorized Official - Credentials:LPC,LCADC
Authorized Official - Phone:609-522-5960
Mailing Address - Street 1:3819 NEW JERSEY AVE
Mailing Address - Street 2:
Mailing Address - City:WILDWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08260-1914
Mailing Address - Country:US
Mailing Address - Phone:609-522-5960
Mailing Address - Fax:609-522-4074
Practice Address - Street 1:3819 NEW JERSEY AVE
Practice Address - Street 2:
Practice Address - City:WILDWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08260-1914
Practice Address - Country:US
Practice Address - Phone:609-522-5960
Practice Address - Fax:609-522-4074
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-09
Last Update Date:2014-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ2000388261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0411345Medicaid