| NPI | 1134763907 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAMELA GRAYSON-BALTIMORE Executive Director 856-304-4677 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Additional Taxonomies | 251S00000X |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| Enumeration Date | 2019-11-04 |
| Last Update Date | 2019-11-04 |