| NPI | 1568885580 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANE G KOHAN Office Manager 732-910-1427 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2014-01-27 |
| Last Update Date | 2014-01-27 |