| NPI | 1023463635 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUAN ERIC AREVALO Executive Director 347-291-1169 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NY 005377) |
| Enumeration Date | 2016-05-02 |
| Last Update Date | 2016-05-02 |