Organization
COMMUNITY QUEST WOODBINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DANIEL KELLY (CHIEF EXCEUTIVE OFFICER)
(609) 646-0388
Entity
Organization
Contact information
Practice address
1449 DEHIRSCH AVE APT 5, WOODBINE, NJ 08270-2454
(609) 861-3044
Mailing address
6814 TILTON RD, EGG HARBOR TOWNSHIP, NJ 08234-4490
(609) 646-0388
(609) 646-5622
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
06/05/2015
Last updated
07/21/2022
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