Organization
PENNREACH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KRYSTAL ODELL (CEO)
(215) 409-5519
Entity
Organization
Contact information
Practice address
111 TRUMAN SQUARE, APT 1109, EDISON, NJ 08817
(215) 409-5519
Mailing address
18 S MAIN ST, ALLENTOWN, NJ 08501-1610
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
07/07/2020
Last updated
07/07/2020
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