| NPI | 1427531698 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FENNEL KPOLIE Vice President 856-495-8287 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2018-09-12 |
| Last Update Date | 2018-09-12 |