| Generation Station Llc | |
|
545 Beckett Rd Suite 105-106 Logan Township NJ 08085-1547 | |
| (856) 467-6687 | |
| (856) 467-8636 |
| Full Name | Generation Station Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 545 Beckett Rd, Logan Township, New Jersey |
| Authorized Official Name and Position | Carla Y Mccrorey (CO-OWNER) |
| Authorized Official Contact | 8564676687 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Generation Station Llc 545 Beckett Rd Suite 105-106 Logan Township, (swedesboro) NJ 08085 Ph: (856) 467-6687 | Generation Station Llc 545 Beckett Rd Suite 105-106 Logan Township NJ 08085-1547 Ph: (856) 467-6687 |
| NPI Number | 1558703660 |
|---|---|
| Provider Enumeration Date | 07/18/2013 |
| Last Update Date | 06/12/2014 |
| Medicare PECOS PAC ID | 9335364645 |
|---|---|
| Medicare Enrollment ID | O20140630001246 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558703660 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (New Jersey) | Primary |
| Provider Name | Linda M Melendez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1922156306 PECOS PAC ID: 3577503572 Enrollment ID: I20050510000229 |
| Provider Name | Stephanie A Scanzano |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1700080751 PECOS PAC ID: 9638506249 Enrollment ID: I20200220001372 |
Holistic Healing Counseling Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 24 Monroe St, Logan Township, NJ 08085 Phone: 267-235-2077 |