| NPI | 1902250731 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KHADIJAH ISMAEL Board Of Director 973-979-6144 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NJ 44SC00856100) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: NJ 44SC00856100) |
| 101Y00000X Counselor (Licence: NJ 44SL06046000) | |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NJ 44SC00856100) | |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NJ 44SL06046000) | |
| 101YM0800X Counselor, Mental Health (Licence: NJ 44SC00856100) | |
| 103K00000X Behavior Analyst (Licence: NJ 44SC00856100) | |
| 103K00000X Behavior Analyst (Licence: NJ 44SL06046000) | |
| 1041C0700X Social Worker, Clinical (Licence: NJ 44SL06046000) | |
| Enumeration Date | 2016-04-18 |
| Last Update Date | 2016-04-18 |