| NPI | 1043520240 |
|---|---|
| Doing Business As | STATE COLLEGE MEDICAL |
| Entity Type | Organization |
| Authorized Contact | ROBYN TANIS Executive Director Of Contract Mgmt 856-533-8762 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2800X Clinic/Center Methadone |
| Enumeration Date | 2010-10-21 |
| Last Update Date | 2019-12-23 |