| NPI | 1770330730 |
|---|---|
| Other Name | STANFORD ANGELS LLC |
| Entity Type | Organization |
| Authorized Contact | CATINA BURKETT Social Work Clinical Supervisor 201-814-2759 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2024-05-06 |
| Last Update Date | 2024-08-20 |