| NPI | 1811416019 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELENA HAMMER Billing Manager 732-389-0697 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| Enumeration Date | 2017-09-19 |
| Last Update Date | 2023-03-15 |