| NPI | 1013766062 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMY BUCKLEY Clinical Social Worker 631-942-5733 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2024-05-14 |
| Last Update Date | 2024-05-14 |