South Jersey Behavioral Health Resources

Primary specialty

Mental Illness Intermediate Care FacilityTaxonomy code 310500000X

License

26NP05603800 Issued in NJ

Legal business name

SOUTH JERSEY BEHAVIORAL HEALTH RESOURCES

Practice address

2500 McClellan Ave Ste 300
Pennsauken, NJ 08109-0001

Phone

(856) 361-1100

NPI assigned

May 14, 2015

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Miss Delilah Dragon

Title

LPN

Phone

(856) 577-3964

Specialties & licenses 2

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1431561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1431561600000",
    "number": "1497133094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 HICKORY CT APT C",
            "city": "MAPLE SHADE",
            "state": "NJ",
            "postal_code": "080521950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 MCCLELLAN AVE STE 300",
            "city": "PENNSAUKEN",
            "state": "NJ",
            "postal_code": "081090001",
            "telephone_number": "856-361-1100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH JERSEY BEHAVIORAL HEALTH RESOURCES",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-14",
        "last_updated": "2015-05-14",
        "status": "A",
        "authorized_official_last_name": "DRAGON",
        "authorized_official_first_name": "DELILAH",
        "authorized_official_title_or_position": "LPN",
        "authorized_official_telephone_number": "856-577-3964",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "310500000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Mental Illness",
            "state": "NJ",
            "license": "26NP05603800",
            "primary": true
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NJ",
            "license": "26NP05063800",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lasandra Smalley, LPN
• Marie M Smedile, COTA
• Herbert Smith, LPN
• Patricia Ann Smith, R.N.WCC
• Ji Yeong Son, PHARMD
• South Jersey Behavioral Health Resources, Inc.
• South Jersey Behavioral Health Resources, Inc.
• South Jersey Primary Care Physicians & Rehabilitation Center P.C.
• Specialty Logistics Management LLC
• Kathleen Speck

• Mental Illness Intermediate Care Facility in Pennsauken, NJ
• Providers in Pennsauken, NJ by specialty
• Mental Illness Intermediate Care Facility in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.