| NPI | 1487177101 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE IANNELLI Sole Member 848-251-2642 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) (Licence: NJ 44SC05660900) |
| Enumeration Date | 2017-07-25 |
| Last Update Date | 2022-07-21 |