Provider Demographics
NPI:1841841137
Name:SOLSTICE COUNSELING SERVICES CORP.
Entity type:Organization
Organization Name:SOLSTICE COUNSELING SERVICES CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MANDALE
Authorized Official - Suffix:
Authorized Official - Credentials:JD
Authorized Official - Phone:609-288-8844
Mailing Address - Street 1:300 BIRMINGHAM RD
Mailing Address - Street 2:
Mailing Address - City:PEMBERTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08068-1326
Mailing Address - Country:US
Mailing Address - Phone:609-288-8844
Mailing Address - Fax:609-288-7210
Practice Address - Street 1:300 BIRMINGHAM RD
Practice Address - Street 2:
Practice Address - City:PEMBERTON
Practice Address - State:NJ
Practice Address - Zip Code:08068-1326
Practice Address - Country:US
Practice Address - Phone:609-288-8844
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SOLSTICE COUNSELING SERVICES CORP.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-09-27
Last Update Date:2021-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0280925Medicaid