| NPI | 1457797201 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENISE WINANT Credentialing Supervisor 856-439-6111 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2800X Clinic/Center, Methadone Clinic |
| Enumeration Date | 2013-05-21 |
| Last Update Date | 2023-08-24 |