| NPI | 1366823619 |
|---|---|
| Former Legal Business Name | INTERSERV SERVICES, INC. |
| Entity Type | Organization |
| Authorized Contact | MICHELE DIFABIO Controller 973-564-7557 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities (Licence: NJ GH1119) |
| Enumeration Date | 2015-06-12 |
| Last Update Date | 2015-06-12 |