| NPI | 1811109572 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK ROBERTS CEO 732-376-6601 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) (Licence: NJ 23973) |
| Enumeration Date | 2007-05-04 |
| Last Update Date | 2009-10-20 |