| NPI | 1942359682 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL FISH Owner 732-814-6900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NJ 72701-01-05) |
| Enumeration Date | 2007-01-10 |
| Last Update Date | 2020-08-22 |