| NPI | 1679997100 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SARA DE BERNAL Executive Director 201-289-2832 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center Multi-Specialty (Licence: NJ 2000433) |
| Additional Taxonomies | 261QM0850X Clinic/Center Adult Mental Health (Licence: NJ 2000433) |
| 261QM0855X Clinic/Center Adolescent and Children Mental Health (Licence: NJ 2000433) | |
| 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder (Licence: NJ 2000433) | |
| Enumeration Date | 2014-02-04 |
| Last Update Date | 2014-02-06 |