| NPI | 1043631476 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBYN TANIS Executive Director Of Contract Mgmt 856-533-8762 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2800X Clinic/Center, Methadone Clinic (Licence: GA NTP001074) |
| Additional Taxonomies | 261QR0800X Clinic/Center, Recovery Care |
| Enumeration Date | 2014-01-03 |
| Last Update Date | 2024-03-04 |