| NPI | 1336643295 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH KARL BOETTCHER Cro 856-669-0217 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2018-03-23 |
| Last Update Date | 2018-03-23 |