| NPI | 1184862443 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAMELA MAE NIELSEN Director 609-970-4680 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NJ 37PC00250000) |
| Additional Taxonomies | 251S00000X (Licence: NJ 37PC00250000) |
| 302F00000X Exclusive Provider Organization (Licence: NJ 37PC00250000) | |
| 305R00000X Preferred Provider Organization (Licence: NJ 37PC00250000) | |
| Enumeration Date | 2009-01-25 |
| Last Update Date | 2009-01-25 |