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SOUTHGATE RESIDENTIAL LIFE CENTER
NPI 1699002865
Residential Treatment Facility, Emotionally Disturbed Children in Mount Holly, NJ

Active since November 10, 2009
2630 ROUTE 206, MOUNT HOLLY, NJ 08060(609) 288-6398 Get Directions Write a Review

NPPES record last updated: November 10, 2009. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Southgate Residential Life Center NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SOUTHGATE RESIDENTIAL LIFE CENTER (NPI 1699002865) is a healthcare organization registered as a residential treatment facility, emotionally disturbed children in Mount Holly, New Jersey and active in the NPI registry since November 2009. The organization lists Lawrence Davis, Member, as its authorized official.

NPPES Registry Identity

NPI1699002865
Entity TypeOrganization
Primary Taxonomy322D00000X
Legal Business NameSOUTHGATE RESIDENTIAL LIFE CENTER
Location Address2630 ROUTE 206Mount Holly, NJ 08060-6708
Mailing Address2630 Route 206Mount Holly, NJ 08060-6708 · (609) 288-6398
Phone(609) 288-6398
Organization SubpartNo
Authorized OfficialLawrence DavisMember · (609) 288-6398
Enumeration DateNovember 10, 2009
✔ NPI 1699002865 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyResidential Treatment Facility, Emotionally Disturbed ChildrenResidential Treatment Facilities
Taxonomy Code322D00000X
Definition
A residential facility that provides habilitation services and other care and treatment to children diagnosed with mental health illness, behavioral issues, and intellectual disabilities and are not able to live independently.
2630 ROUTE 206, Mount Holly, NJ 08060
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Other Identifiers 2

Medicaid1946510NJ
Other1700049475NJ · Individual

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Southgate Residential Life Center's NPI number?

The NPI number for Southgate Residential Life Center is 1699002865. It was assigned to this organization in the NPPES registry on November 10, 2009.

Where is Southgate Residential Life Center located?

Southgate Residential Life Center is located at 2630 Route 206, Mount Holly, NJ 08060. The listed phone number is (609) 288-6398.

What is Southgate Residential Life Center's specialty?

The primary specialty registered for this NPI is Residential Treatment Facility, Emotionally Disturbed Children with taxonomy code 322D00000X.

When was this NPI record last updated?

The NPPES record for Southgate Residential Life Center was last updated on November 10, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.