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Organization

ALFA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. ASHIER RESPES (OWNER)
(856) 428-1100
Entity
Organization

Contact information

Practice address
10 LAKESIDE AVE, CHERRY HILL, NJ 08003-3611
(856) 428-1100
Mailing address
10 LAKESIDE AVE, CHERRY HILL, NJ 08003-3611
(856) 428-1100

Taxonomy

Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
261QD1600X
Developmental Disabilities Clinic/Center
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
NJ
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
NJ

Other

Enumeration date
08/15/2017
Last updated
03/27/2019
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