| 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 |