| NPI | 1861923948 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEANINE E. GRAVES Administrator 201-310-6947 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TA0400X Psychologist, Addiction (Substance Use Disorder) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 101YM0800X Counselor, Mental Health | |
| Enumeration Date | 2017-03-21 |
| Last Update Date | 2017-03-21 |