| NPI | 1710400106 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MONDAY J GABRIEL Administrator 856-278-5188 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 311Z00000X Custodial Care Facility |
| 3104A0630X Assisted Living Facility, Assisted Living, Behavioral Disturbances | |
| 320700000X Residential Treatment Facility, Physical Disabilities | |
| 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| Enumeration Date | 2017-07-18 |
| Last Update Date | 2017-07-21 |