| NPI | 1477055861 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GERALDINE DIERKING Owner 732-930-0024 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: NJ 44SC05708400) |
| Enumeration Date | 2018-03-02 |
| Last Update Date | 2018-03-02 |