| NPI | 1235872219 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALBERT S GIPLE Administrator 609-516-6249 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2022-04-18 |
| Last Update Date | 2022-04-18 |