| NPI | 1992402531 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREW WIDOTA COO 609-480-9853 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| 324500000X Substance Abuse Rehabilitation Facility | |
| 261QM0801X | |
| Enumeration Date | 2023-02-14 |
| Last Update Date | 2023-02-14 |