| NPI | 1205169968 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN B HUDOME Owner 856-438-5256 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health (Licence: NJ 44SC01389300) |
| Additional Taxonomies | 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: NJ 44SC01389300) |
| Enumeration Date | 2009-09-14 |
| Last Update Date | 2009-09-14 |