| NPI | 1790210862 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN MICHAEL MUCCINO COO 732-230-2570 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NJ 37PC00452900) |
| Enumeration Date | 2017-04-26 |
| Last Update Date | 2018-04-02 |