| NPI | 1295382646 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBYN TANIS Executive Director Of Contract Mana 856-533-8762 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM2800X Clinic/Center Methadone |
| Enumeration Date | 2019-08-21 |
| Last Update Date | 2019-12-23 |