| 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 Day Training, Developmentally Disabled Services | |
| 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 |