| NPI | 1750149043 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEVI COMBS CEO 856-425-2442 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251X00000X Supports Brokerage |
| Additional Taxonomies | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| 385HR2060X Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child | |
| Enumeration Date | 2024-03-11 |
| Last Update Date | 2024-03-11 |