| NPI | 1013735851 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES BOOZAN Consultant 609-955-6507 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2024-10-01 |
| Last Update Date | 2024-10-01 |