| NPI | 1114116472 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANE BRUESSOW Managing Member 908-647-1688 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: NJ 25MA05818600) |
| Enumeration Date | 2007-10-23 |
| Last Update Date | 2024-04-08 |