| NPI | 1063287845 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES BOOZAN Licensing Consultant 609-955-6507 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2023-11-21 |
| Last Update Date | 2024-04-18 |