Organization
PERSON CENTERED CARE
Active
Organization
PERSON CENTERED CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY YOUSSEF (OWNER/DIRECTOR)
(856) 373-6828
Entity
Organization
Contact information
Practice address
730 N TUCKAHOE RD, WILLIAMSTOWN, NJ 08094-3512
(856) 373-6828
Mailing address
730 N TUCKAHOE RD, WILLIAMSTOWN, NJ 08094-3512
(856) 373-6828
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
251E00000X
Home Health Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
253Z00000X
In Home Supportive Care Agency
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
—
347C00000X
Private Vehicle
—
—
385H00000X
Respite Care
—
—
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
—
—
Other
Enumeration date
11/28/2018
Last updated
11/28/2018
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