| NPI | 1114307618 |
|---|---|
| Doing Business As | SUPPORTIVE LIVING 43 NEWPORT COURT |
| Entity Type | Organization |
| Authorized Contact | LAURA WILLIAMS Executive Director 732-363-3335 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2015-06-01 |
| Last Update Date | 2015-08-18 |