Organization
GRANDULAR SENIOR LIVING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DEBORAH DICKERSON ED.S (OWNER)
(856) 875-9605
Entity
Organization
Contact information
Practice address
542 BERLIN CROSS KEY ROAD STE 3-270, SICKLERVILLE, NJ 08081
(856) 875-9608
Mailing address
542 BERLIN CROSS KEY ROAD STE 3-270, SICKLERVILLE, NJ 08081
(856) 875-9608
Taxonomy
Speciality
Code
Description
License number
State
373H00000X
Day Training/Habilitation Specialist
Primary
0450254579
NJ
Other
Enumeration date
04/18/2018
Last updated
04/18/2018
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