National Provider Identifier Database

PENNREACH
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities

A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities


Contact Information

PENNREACH
111 TRUMAN SQUARE
APT 1208
EDISON, NJ08817
Phone: 215-409-5519
Fax:
Website:
Specialty Taxonomy Code
* Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities 320900000X

* Indicates primary specialty

NPI Profile & details for PENNREACH

NPI Number 1336767219
Legal business name
LBN
PENNREACH
Authorized official KRYSTAL ODELL - (CEO)
Entity Organization
Organization subpart No
Enumeration date 07/08/2020
Last updated 07/08/2020 - About 6 years ago
Sole proprietor1 Not specified
Identifiers n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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