NPI | 1194160507 |
---|---|
Entity Type | Organization |
Authorized Contact | LISA MARIE TORTORELLO-GILLIGAN Owner 732-609-0169 |
Organization Subpart ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NJ 44SC05364900) |
Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
Enumeration Date | 2013-04-30 |
Last Update Date | 2020-10-09 |