| NPI | 1003456575 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGORY BRYAN MARCELLE CEO 631-805-3257 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YM0800X Counselor Mental Health | |
| 101YP2500X Counselor Professional | |
| 251B00000X Case Management | |
| Enumeration Date | 2020-01-13 |
| Last Update Date | 2022-02-10 |