| NPI | 1790324747 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISSA EDMOND Owner/Apn 973-358-5558 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2019-12-22 |
| Last Update Date | 2021-08-03 |