| NPI | 1003276015 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN MUNDOR ROSS President 917-273-6275 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: NY 005123) |
| Enumeration Date | 2016-03-03 |
| Last Update Date | 2018-10-17 |