| NPI | 1336301845 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANA J JAWORSKI Billing Supervisor 201-935-3322 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 261QM2500X Clinic/Center, Medical Specialty |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| 101YM0800X Counselor, Mental Health | |
| Enumeration Date | 2008-06-26 |
| Last Update Date | 2012-03-06 |