| NPI | 1871012138 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THERESA WILSON President/CEO 856-655-1211 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: NJ 40301D05140) |
| Enumeration Date | 2017-09-18 |
| Last Update Date | 2017-09-18 |