| NPI | 1619644069 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOCELYN THOMAS Credentialer/Biller 201-241-0079 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| Enumeration Date | 2021-08-24 |
| Last Update Date | 2024-05-29 |