NPI | 1912472473 |
---|---|
Entity Type | Organization |
Authorized Contact | LLOYD A WYNN COO 973-558-8514 |
Organization Subpart ? | No |
Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
Enumeration Date | 2018-10-10 |
Last Update Date | 2018-10-10 |