| NPI | 1003413311 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MONICA ELKESHK Executive Director 917-463-6166 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Additional Taxonomies | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| 251J00000X Nursing Care | |
| Enumeration Date | 2020-10-08 |
| Last Update Date | 2025-10-15 |