# POTENTIAL UNCHARTED

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1679223176
- **Authorized official:** MR. LEE H PAYNE (CO-OWNER)
- **Authorized official phone:** (914) 672-3973

## Contact information

- **Practice address:** 2 ARNOT ST UNIT 455, LODI, NJ 07644-1629
- **Practice address phone:** (914) 672-3973
- **Mailing address:** 2 ARNOT ST UNIT 455, LODI, NJ 07644-1629
- **Mailing address phone:** (914) 672-3973

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251C00000X | Developmentally Disabled Services Day Training Agency | — | NULL | — |
| 320600000X | Intellectual and/or Developmental Disabilities Residential Treatment Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 03/27/2022
- **Last updated:** 03/27/2022