| Stable Community Services | |
|
513 High St Burlington City NJ 08016-4503 | |
| (609) 386-0650 | |
| (609) 386-0652 |
| Full Name | Stable Community Services |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 513 High St, Burlington City, New Jersey |
| Authorized Official Name and Position | Stacey Delaine Waller (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 6093860650 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Stable Community Services 513 High St Burlington City NJ 08016-4503 Ph: (609) 386-0650 | Stable Community Services 513 High St Burlington City NJ 08016-4503 Ph: (609) 386-0650 |
| NPI Number | 1568885663 |
|---|---|
| Provider Enumeration Date | 01/24/2014 |
| Last Update Date | 06/17/2022 |
| Certification Date | 06/17/2022 |
| Medicare PECOS PAC ID | 9436374022 |
|---|---|
| Medicare Enrollment ID | O20140716000781 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568885663 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (New Jersey) | Primary |
| Provider Name | Eva Sleczka |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1124252309 PECOS PAC ID: 4789738188 Enrollment ID: I20090819000837 |
| Provider Name | Agiliga A Muomah |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841662566 PECOS PAC ID: 3274824677 Enrollment ID: I20160615000314 |
| Provider Name | Omotayo Elizabeth Awujoola |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194932392 PECOS PAC ID: 8426333774 Enrollment ID: I20170328002804 |
| Provider Name | Claudia M Teh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366992554 PECOS PAC ID: 2062799158 Enrollment ID: I20170427000123 |
| Provider Name | Alice L Kalu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245870658 PECOS PAC ID: 3870929698 Enrollment ID: I20200213002663 |
| Provider Name | Ashley Anderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124663679 PECOS PAC ID: 6002238474 Enrollment ID: I20200612002282 |
| Provider Name | Robyera Revoal |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1194104844 PECOS PAC ID: 3274937693 Enrollment ID: I20210807000021 |
| Provider Name | Esther Chidinma Onwu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063087385 PECOS PAC ID: 7416354410 Enrollment ID: I20210917000790 |
| Provider Name | Stacey D Waller |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1730581349 PECOS PAC ID: 6709002330 Enrollment ID: I20220502001206 |
| Provider Name | Fausat F Odubiyi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881174654 PECOS PAC ID: 0749603496 Enrollment ID: I20220512000298 |
| Provider Name | Susan C Jackson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619722972 PECOS PAC ID: 8022555143 Enrollment ID: I20240806003596 |