| NPI | 1043682149 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELIEZER SANTIAGO President 732-410-7102 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health (Licence: NJ 2000575) |
| Additional Taxonomies | 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: NJ 20005750575) |
| Enumeration Date | 2015-10-28 |
| Last Update Date | 2015-10-28 |