Organization
PENNREACH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAULINE BAILO (DIRECTOR)
(215) 475-2401
Entity
Organization
Contact information
Practice address
1998 ROUTE 18, OLD BRIDGE, NJ 08857-3779
(732) 968-4523
Mailing address
18 S MAIN ST, ALLENTOWN, NJ 08501-1610
(732) 968-4523
(609) 259-4120
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
11/21/2017
Last updated
11/21/2017
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