| NPI | 1740639004 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACQUELINE GILL PUCCI Owner 973-525-9356 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NJ 37PC00411900) |
| Enumeration Date | 2016-06-08 |
| Last Update Date | 2017-03-09 |