| NPI | 1992243968 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAUREL MALLON Clinical Therapist 732-455-2084 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NJ 37PC00486400) |
| Enumeration Date | 2017-02-09 |
| Last Update Date | 2017-02-09 |