| NPI | 1770957086 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STACEY JANE NICHOLS Owner/Counselor 385-313-0680 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NJ 44SC05656600) |
| Enumeration Date | 2015-11-24 |
| Last Update Date | 2015-11-24 |