| NPI | 1407953896 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VANESSA GOURDINE Clinical Director 201-488-6678 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2020-08-22 |