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Organization
POTENTIAL UNCHARTED
Active
Organization
POTENTIAL UNCHARTED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LEE H PAYNE (CO-OWNER)
(914) 672-3973
Entity
Organization
Contact information
Practice address
2 ARNOT ST UNIT 455, LODI, NJ 07644-1629
(914) 672-3973
Mailing address
2 ARNOT ST UNIT 455, LODI, NJ 07644-1629
(914) 672-3973
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
—
NULL
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
NULL
Other
Enumeration date
03/27/2022
Last updated
03/27/2022
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