| NPI | 1760965297 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA A. CHARLTON Owner 856-495-2480 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2018-09-11 |
| Last Update Date | 2018-10-19 |