| NPI | 1740051879 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHARONDA BEVERLY Chief Operations Officer 856-436-0035 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2024-01-09 |
| Last Update Date | 2024-09-06 |