| NPI | 1487694832 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY E GARNER CEO 973-790-6594 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) (Licence: NJ 71672) |
| Additional Taxonomies | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) (Licence: NJ 82304) |
| Enumeration Date | 2006-06-07 |
| Last Update Date | 2007-08-23 |