| NPI | 1548772668 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBBIE LEIGH DODGE Lmhc 856-371-6602 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: FL MH14195) |
| Enumeration Date | 2017-10-30 |
| Last Update Date | 2017-10-30 |