| NPI | 1396565727 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IDA JELTOVA Clinical Director 201-757-0600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 261QD1600X Clinic/Center Developmental Disabilities |
| 261QM0855X Clinic/Center Adolescent and Children Mental Health | |
| Enumeration Date | 2024-10-11 |
| Last Update Date | 2024-10-11 |