| NPI | 1003109471 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSE M. COOPER CEO 856-858-5850 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: NJ 2000505-11) |
| Enumeration Date | 2011-05-18 |
| Last Update Date | 2011-05-18 |