| NPI | 1932512092 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACK O'LEARY CEO 732-376-9333 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) (Licence: NJ 24835) |
| Enumeration Date | 2014-06-06 |
| Last Update Date | 2023-01-27 |