| NPI | 1427598101 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAUREEN O'DEA Clinical Director 917-667-4340 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NJ 44SC05381000) |
| Enumeration Date | 2017-03-01 |
| Last Update Date | 2017-03-01 |