NPI | 1104582816 |
---|---|
Entity Type | Organization |
Authorized Contact | GERARD GALLUCCI Acting Medical Director 302-255-2838 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
Additional Taxonomies | 261QD0000X Clinic/Center Dental |
Enumeration Date | 2021-11-17 |
Last Update Date | 2021-11-22 |