| NPI | 1366142226 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOMINIQUE RADCLIFFE Owner 856-215-0399 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 251B00000X Case Management |
| 251C00000X | |
| 320800000X Community Based Residential Treatment Facility, Mental Illness | |
| 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| Enumeration Date | 2023-03-08 |
| Last Update Date | 2023-03-08 |