| NPI | 1730482621 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBYN TANIS Executive Director Of Contract Mgmt 856-533-8762 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2800X Clinic/Center, Methadone Clinic |
| Additional Taxonomies | 251S00000X (Licence: GA PHOP000056) |
| 261QR0800X Clinic/Center, Recovery Care | |
| Enumeration Date | 2010-12-15 |
| Last Update Date | 2020-09-02 |