| NPI | 1457037731 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARLA R VITOLA Owner 732-640-8471 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2023-06-22 |
| Last Update Date | 2023-07-03 |