OrganizationActive
Southgate Residential Life Center
NPI 1699002865 · Emotionally Disturbed Childrens' Residential Treatment Facility · Mount Holly, NJ
Provider details
- NPI number
- 1699002865
- Entity type
- Organization
- Primary specialty
- Emotionally Disturbed Childrens' Residential Treatment FacilityResidential Treatment Facilities
- Organization subpart
- No
- Authorized official
- Lawrence Davis, Member(609) 288-6398
Specialties & taxonomies
Residential Treatment Facilities
Practice location
2630 Route 206
Mount Holly, NJ 08060-6708
Phone: (609) 288-6398
Approximate (ZIP-level) locationGet directions
Mailing address
2630 Route 206
Mount Holly, NJ 08060-6708
Registry dates
- Enumerated
- 2009-11-10
- Last updated
- 2009-11-10
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.