| NPI | 1033629167 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL MARIANO Owner 973-876-6902 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101Y00000X Counselor |
| Additional Taxonomies | 324500000X Substance Abuse Rehabilitation Facility (Licence: NJ 37LC00237300) |
| Enumeration Date | 2017-10-03 |
| Last Update Date | 2020-07-01 |