| NPI | 1578968673 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALLISON TYLER Ican Program Director 973-763-9900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NJ 40QA01001600) |
| Enumeration Date | 2014-10-31 |
| Last Update Date | 2022-08-29 |