| NPI | 1710980917 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THERESA BERGER CEO 732-363-6655 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) (Licence: NJ 23027) |
| Enumeration Date | 2005-05-23 |
| Last Update Date | 2020-08-22 |