| NPI | 1275977696 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELA DITARANTO Executive Director 848-525-6649 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: 305R00000X) |
| Additional Taxonomies | 385H00000X Respite Care (Licence: 385H00000X) |
| 385HR2060X Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child (Licence: 385HR2050X) | |
| 385HR2060X Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child (Licence: 385HR2060X) | |
| Enumeration Date | 2013-04-29 |
| Last Update Date | 2013-04-29 |