| NPI | 1871828525 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN LOISEAU Sole Proprietor 609-503-7377 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NJ 37PC00389100) |
| Enumeration Date | 2009-10-14 |
| Last Update Date | 2018-04-02 |