| NPI | 1811451057 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACQIELINE D BAXLEY Executive Director 908-463-5514 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YM0800X Counselor, Mental Health | |
| Enumeration Date | 2019-01-22 |
| Last Update Date | 2021-01-14 |