| NPI | 1578817755 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RUSSELL MICOLI Coporate Director 856-488-6734 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2012-11-09 |
| Last Update Date | 2012-11-09 |