| NPI | 1801417936 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID FARACHE CEO 856-475-6166 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2020-04-29 |
| Last Update Date | 2020-04-29 |