| NPI | 1720437890 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHIRLEY-ANN MOSES Mgr 201-214-8142 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| 261QD1600X Clinic/Center, Developmental Disabilities | |
| Enumeration Date | 2016-06-08 |
| Last Update Date | 2016-06-08 |