| NPI | 1063872497 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VLADIMIR CHRISTOPHE Owner 201-746-5279 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NJ 44SC05631600) |
| Enumeration Date | 2016-02-26 |
| Last Update Date | 2017-01-17 |