NPI | 1003972654 |
---|---|
Entity Type | Organization |
Authorized Contact | DENISE WINANT Credentialing Supervisor 732-570-0268 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM2800X Clinic/Center, Methadone Clinic |
Enumeration Date | 2006-12-28 |
Last Update Date | 2023-09-17 |