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Organization
N/A
Active
Organization
N/A
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAMWEL GITONGA (OWNER)
(848) 203-8264
Entity
Organization
Contact information
Practice address
304 PERSHING AVE, CARTERET, NJ 07008-3025
(848) 203-8264
Mailing address
304 PERSHING AVE, CARTERET, NJ 07008-3025
(848) 203-8264
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
NULL
Other
Enumeration date
09/05/2022
Last updated
09/05/2022
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