| NPI | 1255961629 |
|---|---|
| Other Name | EVELYN DOUGLIN CENTER ICF- CHESTER |
| Entity Type | Organization |
| Authorized Contact | JESSICA MOJICA Billing Credentialing Manager 917-485-7291 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2020-01-24 |
| Last Update Date | 2020-01-24 |