| NPI | 1669650537 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TINA DONYETTA FRAZIER Owner 856-366-7064 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MD M11443) |
| Enumeration Date | 2008-02-04 |
| Last Update Date | 2016-07-06 |