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Organization

STAR ALLIANCE SUPPORT SERVICES

Active
Other names
STAR ALLIANCE SUPPORT SERVICES
Organization subpart
No

Provider details

NPI number
Authorized official
MISS PRISCILLA YAYRA KLUTSE (ADMINISTRATOR)
(609) 922-9061
Entity
Organization

Contact information

Practice address
615 CUTLER AVE, MAPLE SHADE, NJ 08052-2914
(609) 922-9061
(856) 382-7926
Mailing address
615 CUTLER AVE, MAPLE SHADE, NJ 08052-2914
(609) 922-9061
(856) 382-7926

Taxonomy

Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
251C00000X
Developmentally Disabled Services Day Training Agency
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care

Other

Enumeration date
11/07/2022
Last updated
11/07/2022
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