| NPI | 1659135986 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH RICHARD GAGNON Owner 856-699-1719 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| Enumeration Date | 2024-02-07 |
| Last Update Date | 2025-11-24 |