NPI | 1679096796 |
---|---|
Entity Type | Organization |
Authorized Contact | THERESA BERGER CEO 732-363-6655 |
Organization Subpart ? | No |
Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
Enumeration Date | 2017-07-20 |
Last Update Date | 2023-09-14 |