| NPI | 1679041362 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRYAN MATTHEW DISIMONE Account Manager 973-277-5359 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2018-11-11 |
| Last Update Date | 2018-11-11 |