NPI | 1902568348 |
---|---|
Entity Type | Organization |
Authorized Contact | ASHLEY EGLESTON Owner 732-708-6073 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
261QM0850X Clinic/Center, Adult Mental Health | |
Enumeration Date | 2021-10-13 |
Last Update Date | 2021-10-13 |