| NPI | 1386020568 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL GIBBS Therapist 215-200-8298 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NJ 37PC00505300) |
| Enumeration Date | 2015-08-10 |
| Last Update Date | 2015-08-10 |