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Organization

DEAR JAFFA LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
SHIMARA WATSON (PRESIDENT)
(347) 458-5494
Entity
Organization

Contact information

Practice address
309 FELLOWSHIP ROAD, EAST GATE CENTER, SUITE 200, MOUNT LAUREL, NJ 08054
(347) 458-5494
Mailing address
76 SISTERS FARMSTEAD DR, MOUNT LAUREL, NJ 08054-1448
(347) 458-5494

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility

Other

Enumeration date
01/16/2024
Last updated
03/12/2024
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