| NPI | 1174069579 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEEANN WAGNER Vice President 732-290-9040 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NJ 100003004) |
| Enumeration Date | 2017-01-10 |
| Last Update Date | 2020-08-11 |