Organization
EASTERN CHRISTIAN CHILDREN'S RETREAT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAURA LUPICA (CHIEF OPERATING OFFICER)
(201) 848-8005
Entity
Organization
Contact information
Practice address
286 NEWTOWN RD, WYCKOFF, NJ 07481-2606
(201) 848-8005
Mailing address
700 MOUNTAIN AVE, WYCKOFF, NJ 07481-1099
(201) 848-8005
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
A9109288
—
NJ
Enumeration date
11/01/2021
Last updated
05/25/2022
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