| NPI | 1972295285 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MIRIAM GOLDIE WEISS Registered Agent 732-994-7566 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD1600X Clinic/Center, Developmental Disabilities |
| Additional Taxonomies | 251E00000X Home Health |
| 251S00000X Community/Behavioral Health | |
| Enumeration Date | 2023-05-24 |
| Last Update Date | 2023-05-24 |