| NPI | 1437876695 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER LONG- HOLDORFF Director Of Medicaid 908-730-7827 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization |
| Enumeration Date | 2022-10-27 |
| Last Update Date | 2022-10-27 |