| NPI | 1831702562 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | R KACZKA Mbr 908-948-8802 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2020-08-24 |
| Last Update Date | 2021-12-06 |