| NPI | 1740346386 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENISE WINANT Credentialing Supervisor 732-570-0268 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2800X Clinic/Center, Methadone Clinic (Licence: CA 14836) |
| Additional Taxonomies | 261QM2800X Clinic/Center, Methadone Clinic |
| Enumeration Date | 2006-12-28 |
| Last Update Date | 2023-09-17 |