| NPI | 1730553579 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBRA LYNND DAVIS Owner 201-207-6294 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NJ 35SI00541200) |
| Enumeration Date | 2015-11-17 |
| Last Update Date | 2015-11-17 |