| NPI | 1790857696 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN WURST Director Of Patient Accounts 856-583-2412 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) (Licence: NJ 70471) |
| Enumeration Date | 2006-11-15 |
| Last Update Date | 2019-04-22 |