| NPI | 1760085542 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LATEEFAH KHADEJAH IRVINE Owner 973-393-5188 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Enumeration Date | 2020-11-16 |
| Last Update Date | 2020-11-16 |