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Organization
PENNREACH
Active
Organization
PENNREACH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAULINE BAILO (DIRECTOR)
(215) 409-5519
Entity
Organization
Contact information
Practice address
1482 RAHWAY AVENUE, APT 227, AVENEL, NJ 07001
(215) 409-5519
Mailing address
18 S MAIN ST, ALLENTOWN, NJ 08501-1610
(215) 409-5519
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
NULL
Other
Enumeration date
05/07/2019
Last updated
05/07/2019
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