| NPI | 1770796575 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES WOLFE Executive Director 609-394-8988 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty (Licence: NJ 2000345) |
| Additional Taxonomies | 261Q00000X Clinic/Center (Licence: NJ 2000345) |
| 261QM2800X Clinic/Center, Methadone Clinic (Licence: NJ NJ-10046-M) | |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: NJ 2000345; 2000078) | |
| Enumeration Date | 2007-05-08 |
| Last Update Date | 2020-08-10 |