| NPI | 1972037604 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON GORDON Owner 908-451-2550 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NJ 37PC00488100) |
| Enumeration Date | 2017-04-19 |
| Last Update Date | 2017-04-19 |