Provider First Line Business Practice Location Address:
255 GREENDELL ROAD
Provider Second Line Business Practice Location Address:
FRELINGHUYSEN COMMUNITY RESIDENCE (MATHENY)
Provider Business Practice Location Address City Name:
NEWTON
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07860
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
908-850-8301
Provider Business Practice Location Address Fax Number:
908-850-8309
Provider Enumeration Date:
06/24/2015