| NPI | 1942728423 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAWN GIBSON COO 856-767-5757 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2017-09-05 |
| Last Update Date | 2017-09-05 |