Organization
UNICORN SUPPORTIVE SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MONDAY J GABRIEL (ADMINISTRATOR)
(856) 278-5188
Entity
Organization
Contact information
Practice address
890 E WALNUT RD, VINELAND, NJ 08360-5032
(856) 278-5188
Mailing address
22 VALLEY FORGE DR, SWEDESBORO, NJ 08085-4230
(856) 278-5188
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
05/25/2018
Last updated
05/25/2018
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