| NPI | 1366861940 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GINEAN CRAWFORD Co Owner 856-904-5580 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional |
| Additional Taxonomies | 101Y00000X Counselor |
| 251S00000X Community/Behavioral Health | |
| 261QM0850X Clinic/Center Adult Mental Health | |
| 261QM0855X Clinic/Center Adolescent and Children Mental Health | |
| Enumeration Date | 2014-04-10 |
| Last Update Date | 2014-04-10 |