| NPI | 1023704764 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROLINE SAM Nurse Practitioner 347-734-1070 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2023-04-14 |
| Last Update Date | 2023-04-14 |