Organization
LILLY IN THE VALLEY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHANICE JENKINS (CEO)
(267) 902-2343
Entity
Organization
Contact information
Practice address
1 TOWNE CTR APT 302, CLIFFSIDE PARK, NJ 07010-2050
(718) 964-3545
Mailing address
555 S GODDARD BLVD APT 434, KING OF PRUSSIA, PA 19406-1987
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
—
—
3104A0630X
Assisted Living Facility (Behavioral Disturbances)
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
04/21/2022
Last updated
04/25/2022
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