| NPI | 1598958340 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TYSHAMMIE COOPER DELISLE Manager 973-509-7600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: NJ 2000193-06) |
| Enumeration Date | 2007-08-24 |
| Last Update Date | 2007-08-24 |