Individual provider · Type 1 NPI
Eddie Benjamin Davis Iii
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Woodbury, NJ
Practice location
1966 Melvina Rd
Woodbury, NJ 08096-5613
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| 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.
About NPI 1699305086
Eddie Benjamin Davis Iii's National Provider Identifier is 1699305086, issued on Jan 24, 2020. The primary taxonomy on file is Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility (320900000X), and the practice location is in Woodbury, NJ. The record was last updated on Jan 28, 2020.