| Organization Name: | CHILDREN'S CONTINUUM OF CARE |
| NPI Number: | 1134256712 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | KIMBERLY C. PETKA (EXECUTIVE DIRECTOR) |
| Mailing Address: | 177 S Centre St Suite B Merchantville |
| State: | NJ US |
| Postal Code: | 081092220 |
| Phone Number: | 8566611100 |
| Fax Number: | 8566610910 |
| NPI Enumeration Date: | 02/28/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | 37FI00158500 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NJ |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |