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General NPI Number Information
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NPI Number | 1780149658
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Entity Type | Organization
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Legal Business Name | RANCH HOPE OMEGA
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Dates
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Enumeration Date | 02/05/2019
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Last Update Date | 02/05/2019
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Provider Practice Location Address
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Address Line | 45 SAWMILL ROAD
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City | ALLOWAY
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State | NJ
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Zip | 08001-0325
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Country | US
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Telephone | 856-935-1555
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 325
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City | ALLOWAY
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State | NJ
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Zip | 08001-0325
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Country | US
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Telephone | 856-935-1555
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DAVID BAILEY JR.
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Credential |
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Telephone | 856-935-1555
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 323P00000X
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Taxonomy Name | Psychiatric Residential Treatment Facility
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License Number |
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License Number State |
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