| NPI | 1194223271 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES IDRIS WEBB Co Owner 973-748-0847 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2018-01-24 |
| Last Update Date | 2018-01-25 |