Pennreach

Organization Active NPI Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Woodbridge, NJ

NPI 1962056317 · NPPES record last updated Jul 24, 2019

Key facts

NPI
1962056317
Entity type
Organization (NPI type 2)
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X
Legal business name
PENNREACH
Practice address
1482 Rahway Avenue
Apt 111
Woodbridge, NJ 17001-0850
Phone
(215) 409-5519
NPI assigned
Jul 24, 2019
Organization subpart
No

Authorized official

Name
Krystal Odell
Title
Ceo
Phone
(215) 409-5519

Corporate family (same tax ID) 13

Organizations that report the same tax identification number in the National Provider Directory.

National Provider Directory

Tax ID family
Pennreach (87 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X Yes

Addresses

Primary practice location

1482 Rahway Avenue
Apt 111
Woodbridge, NJ 17001-0850

Mailing address

18 S Main St
Allentown, NJ 08501-1610
Phone (215) 409-5519

Other providers in Woodbridge, NJ

All providers in Woodbridge, NJ · Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in New Jersey

Sources for this page

Verify at the official NPI Registry.