| NPI | 1205155637 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID ANDRE AICHROTH Licensed Clinical Alchol And Drug C 631-219-9503 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NJ 3LC00163100) |
| Additional Taxonomies | 104100000X Social Worker (Licence: NJ 44SL05429400) |
| Enumeration Date | 2010-05-25 |
| Last Update Date | 2016-05-23 |