| NPI | 1619467693 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEEANN WAGNER Vice President 732-290-9040 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NJ 1000054604) |
| Enumeration Date | 2018-05-15 |
| Last Update Date | 2020-08-11 |