| NPI | 1003359100 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ISTRA RIVERA Owner/Director 201-208-5760 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NJ 44SC04763200) |
| Enumeration Date | 2016-11-22 |
| Last Update Date | 2016-11-22 |