| NPI | 1073073995 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ZACH O OYEFESOBI Director 732-829-1555 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2019-03-25 |
| Last Update Date | 2019-03-25 |