| NPI | 1043787880 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHON TYNES Owner 973-856-4404 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 347C00000X Private Vehicle |
| 385HR2060X Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child | |
| Enumeration Date | 2018-10-30 |
| Last Update Date | 2018-10-30 |