| NPI | 1457125965 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONNA COULTER Owner 732-443-0202 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2023-11-14 |
| Last Update Date | 2023-11-14 |