NPI | 1649681099 |
---|---|
Entity Type | Organization |
Authorized Contact | ROBYN TANIS Executive Director Of Contract Mgmt 856-533-8762 |
Organization Subpart ? | Yes |
Primary Taxonomy | 261QM2800X Clinic/Center, Methadone Clinic (Licence: KY 810355) |
Enumeration Date | 2014-05-19 |
Last Update Date | 2019-12-20 |