| NPI | 1437608023 |
|---|---|
| Doing Business As | NONE |
| Entity Type | Organization |
| Authorized Contact | LENORE FAIR Consultant 201-344-9643 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2016-09-24 |
| Last Update Date | 2016-09-24 |