Organization
RANCH HOPE OMEGA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AUGUSTUS P DIBBLE (CFO)
(856) 935-1555
Entity
Organization
Contact information
Practice address
45 SAWMILL ROAD, ALLOWAY, NJ 08001-0325
(856) 935-1555
(856) 935-5189
Mailing address
PO BOX 325, ALLOWAY, NJ 08001-0325
(856) 935-1555
(856) 935-5189
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
37400000X
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0216135
MEDICARE ID-TYPE UNSPECIFIED
NJ
Enumeration date
03/30/2007
Last updated
02/02/2010
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