Pennreach
Residential Treatment Facility, Intellectual and/or Developmental Disabilities in Fort Lee, NJ. Organization (NPI-2).
NPI number1164077681
StatusActive
Last updated in NPPESAug 2, 2019
Details
- NPI
- 1164077681
- Entity type
- Organization (NPI-2)
- Legal business name
- Pennreach
- Organization subpart
- No
- Enumeration date
- Aug 2, 2019
- Last updated
- Aug 2, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 320600000X | Residential Treatment Facility, Intellectual and/or Developmental Disabilities | – | – | Yes |
Practice location
69 Main St Apt 807Fort Lee, NJ 07024-6909
Phone 215-409-5519
Mailing address
18 S Main StAllentown, NJ 08501-1610
Phone 215-409-5519
Authorized official
Krystal Odell
Ceo
2124095519
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