Basic Information
| Provider Information | |||||||||
| NPI: | 1790359529 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ACENDA, INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 42 DELSEA DR S | ||||||||
| Address2: | |||||||||
| City: | GLASSBORO | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 080282621 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8444223632 | ||||||||
| FaxNumber: | 8568815508 | ||||||||
| Practice Location | |||||||||
| Address1: | 9 HARDING HWY | ||||||||
| Address2: | |||||||||
| City: | PITTSGROVE | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 083184401 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8444223632 | ||||||||
| FaxNumber: | 8568815508 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/17/2021 | ||||||||
| LastUpdateDate: | 05/17/2021 | ||||||||
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| AuthorizedOfficialLastName: | WAMPLER | ||||||||
| AuthorizedOfficialFirstName: | JEREMY | ||||||||
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| AuthorizedOfficialTitleorPosition: | CFO | ||||||||
| AuthorizedOfficialTelephone: | 8568818689 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 05/17/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 324500000X | Y | Residential Treatment Facilities | Substance Abuse Rehabilitation Facility |
No ID Information.