Organization
LILLY OF THE VALLEY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHANICE JENKINS (CEO)
(267) 902-2343
Entity
Organization
Contact information
Practice address
1 TOWNE CENTRE DRIVE, SUITE 302, CLIFFSIDE PARK, NJ 07010-2050
(267) 902-2343
Mailing address
555 S GODDARD BLVD APT 434, KING OF PRUSSIA, PA 19406-1987
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
08/16/2022
Last updated
08/16/2022
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