| NPI | 1043774607 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STACEY SEIGEL Ps Supervisor 856-456-2022 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2019-01-29 |
| Last Update Date | 2019-01-29 |