| NPI | 1972192102 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHENELLE SRIWARDENA Psychotherapist 732-631-4297 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2021-01-12 |
| Last Update Date | 2021-01-12 |