| NPI | 1316423460 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENYA SIMON Member 609-915-2390 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2018-07-12 |
| Last Update Date | 2018-07-12 |