| NPI | 1538551072 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TARA MICHELLE KING Director 732-240-2545 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NJ 37LC00034800) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: NJ 37PC00161400) |
| Enumeration Date | 2015-02-20 |
| Last Update Date | 2015-02-20 |