| NPI | 1053640797 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN D HOTTSCLAW Board President 856-225-0505 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2800X Clinic/Center, Methadone Clinic |
| Additional Taxonomies | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: NJ 2000459-09) |
| Enumeration Date | 2009-12-09 |
| Last Update Date | 2022-09-08 |