| NPI | 1609224336 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBYN TANIS Executive Director Of Contract Mgmt 856-533-8762 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2800X Clinic/Center, Methadone Clinic (Licence: GA NTP001085) |
| Additional Taxonomies | 261QR0800X Clinic/Center, Recovery Care |
| Enumeration Date | 2016-06-03 |
| Last Update Date | 2021-09-02 |