| NPI | 1639559693 |
|---|---|
| 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 GH1693) |
| Enumeration Date | 2015-06-04 |
| Last Update Date | 2016-03-11 |