| NPI | 1770047169 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHAVA E ELLINSON Owner 732-276-5828 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2019-01-30 |
| Last Update Date | 2019-01-30 |