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Organization

ALFA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. ASHIER RESPES (CEO)
(856) 449-3190
Entity
Organization

Contact information

Practice address
119 E CLEARVIEW AVE, PINE HILL, NJ 08021-7318
(856) 238-9294
Mailing address
10 LAKESIDE AVE, CHERRY HILL, NJ 08003-3611
(856) 428-1100

Taxonomy

Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility

Other

Enumeration date
03/27/2019
Last updated
03/27/2019
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