| NPI | 1083095095 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL HAGGERTY CEO 609-689-0136 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: NJ SH012) |
| Enumeration Date | 2015-06-16 |
| Last Update Date | 2020-07-20 |