| NPI | 1164957601 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TINA DONYETRTA FRAZIER President 856-366-7064 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: PA M1143) |
| Enumeration Date | 2017-04-21 |
| Last Update Date | 2017-04-21 |