| NPI | 1154777530 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA MARIE RUNNE Medical Biller 973-697-1010 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Additional Taxonomies | 251S00000X |
| 347C00000X Private Vehicle | |
| Enumeration Date | 2016-05-04 |
| Last Update Date | 2016-05-04 |