| NPI | 1982215299 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBYN TANIS Executive Director Of Contract Mgmt 856-533-8762 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2800X Clinic/Center Methadone |
| Additional Taxonomies | 261QR0800X Clinic/Center Recovery Care |
| Enumeration Date | 2020-08-11 |
| Last Update Date | 2020-08-11 |