NPI | 1952654972 |
---|---|
Other Name | PARK PLACE |
Entity Type | Organization |
Authorized Contact | PETER E DOUGHERTY Clinical Supervisor 732-869-2773 |
Organization Subpart ? | Yes |
Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health (Licence: NJ 44SC05427900) |
Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health (Licence: NJ 37LC00188000) |
Enumeration Date | 2012-10-16 |
Last Update Date | 2012-10-16 |