Individual
EDDIE BENJAMIN DAVIS III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1966 MELVINA RD, WOODBURY, NJ 08096-5613
(856) 693-4446
Mailing address
1966 MELVINA RD, WOODBURY, NJ 08096-5613
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
01/24/2020
Last updated
01/28/2020
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