| NPI | 1003348939 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRYSTAL AVIS BLACK Executive Director Of Operations 718-764-9742 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children (Licence: NY 25853) |
| Enumeration Date | 2017-03-30 |
| Last Update Date | 2017-03-30 |