Provider Demographics
NPI:1730880279
Name:SOLSTICE COUNSELING SERVICES CORP.
Entity type:Organization
Organization Name:SOLSTICE COUNSELING SERVICES CORP.
Other - Org Name:<UNAVAIL>
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:609-667-7000
Mailing Address - Fax:609-288-7210
Practice Address - Street 1:411 KINGS HWY S
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08034-2512
Practice Address - Country:US
Practice Address - Phone:609-667-7000
Practice Address - Fax:609-288-7210
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SOLSTICE COUNSELING SERVICES CORP.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-03-13
Last Update Date:2023-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder