| NPI | 1164882502 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE MARKS Clinical Director 201-805-8070 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NJ 1-14-17752) |
| Enumeration Date | 2016-02-27 |
| Last Update Date | 2016-02-27 |