| NPI | 1598130981 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULISSA CORIANO Owner 302-505-5577 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: DE 0000000) |
| Enumeration Date | 2015-12-10 |
| Last Update Date | 2016-12-27 |