| NPI | 1265925796 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALYSE HELENE ERGOOD MCKEAL Licensed Clinical Social Worker 856-438-0694 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2018-06-09 |
| Last Update Date | 2022-08-26 |