Provider Demographics
NPI:1487444931
Name:JOSEPH'S HOUSE OF CAMDEN
Entity type:Organization
Organization Name:JOSEPH'S HOUSE OF CAMDEN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GRANTS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:
Authorized Official - Last Name:DERRICKSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-999-1593
Mailing Address - Street 1:555 ATLANTIC AVE
Mailing Address - Street 2:
Mailing Address - City:CAMDEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08104-1107
Mailing Address - Country:US
Mailing Address - Phone:856-247-1087
Mailing Address - Fax:
Practice Address - Street 1:555 ATLANTIC AVE
Practice Address - Street 2:
Practice Address - City:CAMDEN
Practice Address - State:NJ
Practice Address - Zip Code:08104-1107
Practice Address - Country:US
Practice Address - Phone:856-247-1087
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-08
Last Update Date:2025-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management