| NPI | 1902526635 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TEJASH SHAH Owner 856-712-3505 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered |
| Enumeration Date | 2022-09-01 |
| Last Update Date | 2023-02-17 |