Pennreach

NPI #1083269211 in Fort Lee, New Jersey

Provider Information

NPI Number: 1083269211
Entity Type: Organization
Organization Name: Pennreach
Primary Specialty: Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Enumeration Date: Aug 5, 2019
Last Updated: Aug 5, 2019

Practice Location

Address: 69 MAIN ST APT 712
City: Fort Lee
State: New Jersey
ZIP Code: 07024-6909
Phone: (215) 409-5519

Authorized Official

Name: KRYSTAL ODELL
Title: CEO
Phone: (215) 409-5519

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities	320900000X	Primary

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