| NPI | 1104328483 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANASTASIA VAYNBERG Billing Manager 201-703-3980 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2018-03-02 |
| Last Update Date | 2018-03-02 |