| NPI | 1225529274 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MONDAY GABRIEL Administrator 856-278-5188 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 3104A0630X Assisted Living Facility, Assisted Living, Behavioral Disturbances |
| 311ZA0620X Custodial Care Facility, Adult Care Home | |
| 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| Enumeration Date | 2018-05-25 |
| Last Update Date | 2018-05-25 |