| NPI | 1407249592 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERI BLACK Director 856-575-4196 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2015-03-12 |
| Last Update Date | 2015-03-12 |