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Vivion Larry Bambara
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Lindenwold, New Jersey
NPI 1649857186

Vivion Larry Bambara is a Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility based in Lindenwold, NJ. Vivion Larry Bambara practices in Lindenwold, NJ. The NPI Number for Vivion Larry Bambara is 1649857186 and holds a License No. (New Jersey).

The current practice location address for Vivion Larry Bambara is 101 E Gibbsboro Rd Apt 1611, Lindenwold, NJ and can be reached out via phone at 346-262-7732.

Location: 101 E Gibbsboro Rd Apt 1611, Lindenwold, NJ, 08021-1923
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1649857186
Provider Name
Vivion Larry Bambara
Credential
Provider Entity Type
Individual
Gender
Male
Address
101 E Gibbsboro Rd Apt 1611, Lindenwold, NJ, 08021-1923
Phone Number
346-262-7732
Fax Number
Provider Enumeration Date
03/29/2021
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1649857186 05 NJ
institution
Provider Business Practice Location Address Details
Address
101 E Gibbsboro Rd Apt 1611
City
Lindenwold
State
New Jersey
Zip
08021-1923
Phone Number
346-262-7732
Fax Number
person
Provider Business Mailing Address Details
Address
101 E Gibbsboro Rd Apt 1611
City
Lindenwold
State
New Jersey
Zip
08021-1923
Phone Number
346-262-7732
Fax Number
person
Provider's Taxonomy Details 1
Type
Agencies
Classification
Day Training, Developmentally Disabled Services
Speciality
-
Taxonomy
251C00000X
License No.
(New Jersey)
Definition
These agencies are authorized to provide day habilitation services to developmentally disabled individuals who live in their homes. The function of day habilitation is to assist an individual to acquire and maintain those life skills that enable the individual to cope more effectively with the demands of independent living. Also to raise the level of the individual's physical, mental, social, and vocational functioning.
person
Provider's Taxonomy Details 2
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Adult Day Care
Taxonomy
261QA0600X
License No.
()
Definition
Definition to come...
person
Provider's Taxonomy Details 3
Type
Residential Treatment Facilities
Classification
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Speciality
-
Taxonomy
320900000X
License No.
()
Definition
A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities.
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