Organization
PENN-JERSEY INTEGRATED HUMAN SERVICES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. FENNEL KPOLIE LSW (VICE PRESIDENT)
(856) 495-8287
Entity
Organization
Contact information
Practice address
6272 KINDRED ST, PHILADELPHIA, PA 19149-2805
(215) 964-2135
Mailing address
7515 BOULEVARD AVE, PENNSAUKEN, NJ 08110-2576
(856) 495-8287
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
09/12/2018
Last updated
09/12/2018
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