| NPI | 1467986414 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL MAZZOCCO Assistant Executive Director 212-629-7939 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: NJ GH1033) |
| Enumeration Date | 2017-04-17 |
| Last Update Date | 2017-04-17 |