| NPI | 1992207690 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACY CLOUGH Owner 973-809-4722 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health (Licence: CT 010006) |
| Additional Taxonomies | 251S00000X (Licence: CT 010006) |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: CT 010006) | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: CT 010006) | |
| Enumeration Date | 2018-03-08 |
| Last Update Date | 2018-03-17 |