NPI | 1023524667 |
---|---|
Entity Type | Organization |
Authorized Contact | VIACHESLAV SERGEENKO Controller 609-689-0136 |
Organization Subpart ? | Yes |
Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: NJ SA2524) |
Additional Taxonomies | 253Z00000X In Home Supportive Care (Licence: NJ SA2524) |
Enumeration Date | 2017-12-19 |
Last Update Date | 2018-03-01 |