| NPI | 1659019594 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DASIA RUTH FIELDS Provider 973-938-2767 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2022-05-20 |
| Last Update Date | 2022-05-20 |