| NPI | 1023130580 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LATONDRA M BLACK Therapist 718-304-7022 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: NY 071466-1) |
| Enumeration Date | 2007-04-04 |
| Last Update Date | 2008-06-24 |