| NPI | 1427322916 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAUREN SIVELLE Owner/Director 347-693-5322 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NJ 1-11-9233) |
| Enumeration Date | 2012-02-29 |
| Last Update Date | 2012-03-01 |