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Organization
UNICORN SUPPORTIVE SERVICES
Active
Organization
UNICORN SUPPORTIVE SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MONDAY J GABRIEL (ADMINISTRATOR)
(856) 278-5188
Entity
Organization
Contact information
Practice address
22 VALLEY FORGE DR, SWEDESBORO, NJ 08085-4230
(856) 278-5188
Mailing address
22 VALLEY FORGE DR, SWEDESBORO, NJ 08085-4230
Taxonomy
Speciality
Code
Description
License number
State
3104A0630X
Assisted Living Facility (Behavioral Disturbances)
—
NJ
311Z00000X
Custodial Care Facility
—
NJ
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
NJ
320700000X
Physical Disabilities Residential Treatment Facility
—
NJ
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
NJ
Other
Enumeration date
07/18/2017
Last updated
07/21/2017
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