NPI 1003321654
Shady Rest Residential Facility
Practice location
- Address
- 343 Texas Ave, Mt Laurel, NJ 08054-0805
- Phone
- (856) 668-6610
- Fax
- (856) 668-6610
- Mailing address
- 343 Texas Ave, Mount Laurel, NJ 08054-3510
Authorised official
- Name
- Dioun Young
- Title
- Owner
- Phone
- (856) 668-6610
Registered specialties
In Home Supportive Care Agency
Primary
Registry record
- NPI
- 1003321654
- Entity type
- Organization
- NPI issued
- 5 Dec 2017
- Record last updated
- 5 Dec 2017
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.