| NPI | 1619728953 |
|---|---|
| Other Name | MARYVILLE ADDICTION |
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER DONEGAN Controller 856-227-2717 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2024-03-27 |
| Last Update Date | 2024-03-27 |