| NPI | 1770044935 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VERA BIRYUKOV Owner 856-441-3787 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2019-03-28 |
| Last Update Date | 2019-06-11 |