| NPI | 1619215993 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY S BRENNAN Registered Agent / Owner 973-796-8322 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NJ 37PC00464900) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NJ 37CA00033700) |
| 101YM0800X Counselor, Mental Health (Licence: NJ S4065) | |
| Enumeration Date | 2013-01-22 |
| Last Update Date | 2013-01-22 |