| NPI | 1477933166 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DARREN BLOUGH State Director 856-241-3320 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: NJ GH835) |
| Enumeration Date | 2015-06-08 |
| Last Update Date | 2018-04-03 |