Organization
COMMUNTITY QUEST CORNELL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DANIEL KELLY (CHIEF EXECUTIVE OFFICER)
(609) 646-0388
Entity
Organization
Contact information
Practice address
2 CORNELL RD, SOMERS POINT, NJ 08244-1325
(609) 646-0388
(609) 646-5622
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
06/04/2015
Last updated
06/04/2015
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