Four Walls the 4Walls LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

0400647708 Issued in NJ

Legal business name

FOUR WALLS THE 4WALLS LLC

Practice address

2511 Hamilton Dr
Voorhees, NJ 08043-2642

Phone

(856) 650-6556

NPI assigned

Mar 27, 2016

Last updated

Mar 27, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Jason Ali Brice Sr., M.ED

Title

Executive Director

Phone

(856) 650-6556

Specialties & licenses 1

Addresses

Other names 1

• 4WALLS Other name

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Manu S Kumar, LMFT

  • Marriage & Family Therapist
  • Voorhees, NJ
  • NPI 1578431706
  NPD (past)

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

{
    "created_epoch": "1459036800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1459036800000",
    "number": "1811359060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 201",
            "city": "SOMERDALE",
            "state": "NJ",
            "postal_code": "080830201",
            "telephone_number": "856-650-6556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2511 HAMILTON DR",
            "city": "VOORHEES",
            "state": "NJ",
            "postal_code": "080432642",
            "telephone_number": "856-650-6556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOUR WALLS THE 4WALLS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-27",
        "last_updated": "2016-03-27",
        "status": "A",
        "authorized_official_last_name": "BRICE",
        "authorized_official_first_name": "JASON",
        "authorized_official_middle_name": "ALI",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "856-650-6556",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Sr.",
        "authorized_official_credential": "M.ED"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NJ",
            "license": "0400647708",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "4WALLS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Jeffrey S. Forman, M.D.
• Forsight Brilliance Collaborative
• Karia S Fortune, OTR
• Dolores Marie Foster, RNFA
• Foundation Research Medical Services, P.C. (University Services)
• Jane Fowler, P.A.
• Larissa Mae Fox
• Lisa Marlene Fox, L.C.S.W.
• Dawn Franceschi
• William Culp Franckle IV, M.D.

• Community/Behavioral Health Agency in Voorhees, NJ
• Providers in Voorhees, NJ by specialty
• Community/Behavioral Health Agency in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2016; 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.