NPI | 1184310971 |
---|---|
Doing Business As | BROKEN BOWL LLC |
Entity Type | Organization |
Authorized Contact | CHRISTA BRENNAN Owner 732-275-2979 |
Organization Subpart ? | Yes |
Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
Enumeration Date | 2023-04-13 |
Last Update Date | 2023-04-13 |