| NPI | 1952667644 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN FITZGERALD President 732-257-6662 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: NJ 40003-M40-00-41) |
| Enumeration Date | 2012-04-06 |
| Last Update Date | 2012-04-06 |