| NPI | 1487366589 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAJMARA RHODES Owner 908-875-3204 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center Adult Mental Health |
| Additional Taxonomies | 251E00000X Home Health |
| 261QD1600X Clinic/Center Developmental Disabilities | |
| 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) | |
| 310500000X Intermediate Care Facility, Mental Illness | |
| 320600000X Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | |
| 320700000X Residential Treatment Facility, Physical Disabilities | |
| 320800000X Community Based Residential Treatment Facility, Mental Illness | |
| 320900000X Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | |
| Enumeration Date | 2022-12-20 |
| Last Update Date | 2022-12-20 |