| NPI | 1053794065 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BERTEE THOMAS Program Operations Executive Direct 609-668-4719 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 103TC1900X Psychologist, Counseling |
| 251S00000X | |
| Enumeration Date | 2015-07-08 |
| Last Update Date | 2022-05-15 |