Individual provider · Type 1 NPI
Vivion Larry Bambara
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Lindenwold, NJ
Practice location
101 E Gibbsboro Rd Apt 1611
Lindenwold, NJ 08021-1923
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Developmentally Disabled Services Day Training Agency | 251C00000X | None listed |
| Adult Day Care Clinic/Center | 261QA0600X | None listed |
| Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Primary | 320900000X | None listed |
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility: A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities.
Another provider at this address
About NPI 1649857186
Vivion Larry Bambara's National Provider Identifier is 1649857186, issued on Mar 29, 2021. The primary taxonomy on file is Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility (320900000X), and the practice location is in Lindenwold, NJ. The record was last updated on Jan 1, 2022.