| NPI | 1073974358 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WAYNE EDWARD DUNCN President 551-265-8150 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NJ 44SC05423700) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2016-03-14 |
| Last Update Date | 2016-03-14 |