| NPI | 1174168967 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VINCENT TROY SANTOS Operations Director 201-572-4893 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 251E00000X Home Health |
| Enumeration Date | 2019-11-15 |
| Last Update Date | 2020-10-30 |