| NPI | 1922605070 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MORUFAT TAJUDEEN Executive Director 848-391-4763 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 251E00000X Home Health |
| 385HR2060X Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child | |
| Enumeration Date | 2020-10-01 |
| Last Update Date | 2020-10-02 |