Pennreach

NPI #1265097430 in Fort Lee, New Jersey

Provider Information

NPI Number: 1265097430
Entity Type: Organization
Organization Name: Pennreach
Primary Specialty: Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Enumeration Date: May 3, 2019
Last Updated: Jul 22, 2019

Practice Location

Address: 69 MAIN ST APT 1110
City: Fort Lee
State: New Jersey
ZIP Code: 07024-6909
Phone: (215) 409-5519

Authorized Official

Name: PAULINE BAILO
Title: DIRECTOR
Phone: (215) 475-2401

Specialties & Taxonomy Codes

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

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