| NPI | 1154849180 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELIZABETH MARYEL MAC EWEN Licensed Clinical Social Worker 973-903-1183 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NJ 44SC05589400) |
| Enumeration Date | 2017-08-30 |
| Last Update Date | 2017-08-30 |