| NPI | 1609551233 |
|---|---|
| Former Legal Business Name | N/A |
| Entity Type | Organization |
| Authorized Contact | DARYL STAFFORD CEO 856-449-4664 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2023-06-20 |
| Last Update Date | 2023-06-20 |