| NPI | 1265966220 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHARON TEAGUE Owner 905-956-3875 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NJ 44SC01288200) |
| Enumeration Date | 2017-04-17 |
| Last Update Date | 2017-04-17 |