| NPI | 1992214605 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YOVONNEA CHARMAINE MCKEVER Administrator 856-287-4191 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2017-09-26 |
| Last Update Date | 2022-07-21 |