| NPI | 1487141883 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL R. GANON Medical Director 973-862-4297 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0401X Family Medicine, Addiction Medicine (Licence: NJ 25MB05783900) |
| Enumeration Date | 2018-04-20 |
| Last Update Date | 2023-06-28 |