| NPI | 1275997090 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARKIM SHAKUR-PURVIS Director 732-682-4343 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NJ 37PC00471600) |
| Enumeration Date | 2016-04-07 |
| Last Update Date | 2016-04-26 |