Organization
CHRISTOPHER PEGERON
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTOPHER PEGERON M.A. (EXECUTIVE DIRECTOR)
(973) 232-7743
Entity
Organization
Contact information
Practice address
101 SCALES PLZ APT 213, CLIFTON, NJ 07013-4313
(973) 779-0313
Mailing address
101 SCALES PLZ APT 213, CLIFTON, NJ 07013-4313
(973) 779-0313
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0487716
—
NJ
Enumeration date
08/31/2017
Last updated
07/21/2022
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