| NPI | 1295065803 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL GOCHFELD Program Director 7324-445-0123 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: NJ 25MA08648800) |
| Enumeration Date | 2010-01-04 |
| Last Update Date | 2010-01-04 |