| NPI | 1861515017 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN FITZGERALD C.E.O 732-257-6662 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: NJ 40003-G43-00-41) |
| Additional Taxonomies | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: NJ 40003-G43-00-42) |
| Enumeration Date | 2007-04-10 |
| Last Update Date | 2023-10-23 |