| NPI | 1679089106 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY BRACAGLIA Owner 908-320-5320 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: NJ 37LC00267600) |
| 104100000X Social Worker (Licence: NJ 44SL06310800) | |
| 261QM1300X Clinic/Center Multi-Specialty | |
| 363LF0000X Nurse Practitioner Family (Licence: NJ 26NJ00302100) | |
| 363LP0808X Nurse Practitioner Psychiatric/Mental Health | |
| Enumeration Date | 2017-12-20 |
| Last Update Date | 2023-02-28 |