| NPI | 1154715449 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON O'DONNELL Owner 732-788-7835 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NJ 44SC05541800) |
| Enumeration Date | 2015-03-24 |
| Last Update Date | 2015-03-27 |