| NPI | 1922628502 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CRYSTAL REBECCA SMITH Quality Manager 856-455-7575 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2020-04-23 |
| Last Update Date | 2020-04-23 |