| NPI | 1932961414 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AUGUSTINE DOUGLAS Agency Principal 908-418-6938 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| 261QH0100X Clinic/Center, Health Services | |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| Enumeration Date | 2024-01-29 |
| Last Update Date | 2024-02-01 |