| NPI | 1982373932 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ASHLEY WILLIS Owner 856-392-1123 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 251S00000X |
| 385HR2060X Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child | |
| Enumeration Date | 2021-09-12 |
| Last Update Date | 2022-10-31 |