| NPI | 1942735600 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER LONG Director Of Medicaid Services 908-730-7827 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2017-05-01 |
| Last Update Date | 2017-05-01 |