| NPI | 1902111321 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TARA EDMONSON Member 201-290-0635 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 252Y00000X Early Intervention Provider Agency |
| Enumeration Date | 2010-08-10 |
| Last Update Date | 2010-08-10 |