| NPI | 1013505783 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY TAVERAS-GARCIA License Clinical Social Worker 201-724-5489 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2021-01-07 |
| Last Update Date | 2021-01-07 |