| NPI | 1669007225 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ASLAM ALI Executive Director 862-233-7552 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty |
| 101YP2500X Counselor, Professional | |
| Enumeration Date | 2020-03-04 |
| Last Update Date | 2020-03-04 |