| NPI | 1013030592 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD VARGAS Administrative Supervisor 347-394-5173 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NY 069638) |
| Enumeration Date | 2007-04-09 |
| Last Update Date | 2008-06-24 |