PENNREACH
NPI 1508484486
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities in Edison, NJ

Q: What is the provider's specialty?

The provider's specialty is Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities with taxonomy code 320900000X.

Active since July 08, 2020

111 TRUMAN SQUARE, APT 1210, EDISON, NJ 08817(215) 409-5519 Get Directions Write a Review

NPPES record last updated: July 8, 2020. Verified against the NPPES registry weekly; last sync: July 19, 2026.

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NPI Profile Information
Primary Taxonomy
Authorized Official
Other Providers Same Location
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Organization
Community Based Residential Treatment Fa...

About PENNREACH

This page provides the complete NPI Profile along with additional information for Pennreach, a provider established in Edison, New Jersey operating as a Community Based Residential Treatment Facility, Intellectual And/or Developmental Disabilities. The healthcare provider is registered in the NPI registry with number 1508484486 assigned on July 2020. The practitioner's primary taxonomy code is 320900000X. The provider is registered as an organization and their NPI record was last updated 6 years ago. The authorized official of this NPI record is Krystal Odell (Ceo)

NPI: 1508484486 Verify this NPI
Provider Name: PENNREACH
Entity Type: Organization
Location Address: 111 TRUMAN SQUARE APT 1210 EDISON, NJ 08817
Location Phone: (215) 409-5519
Mailing Address: 18 S MAIN ST ALLENTOWN, NJ 08501
Is Sole Proprietor?: No
Is Organization Subpart?: No
Enumeration Date: 07-08-2020
Last Update Date: 07-08-2020
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification: Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Taxonomy Code: 320900000X
Type: Residential Treatment Facilities
Taxonomy Description: A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name: KRYSTAL ODELL
Authorized Official Title: CEO
Authorized Official Phone: (215) 409-5519