| NPI | 1033081740 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATERSLEY GENE Owner 516-943-8731 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2025-09-22 |
| Last Update Date | 2025-09-22 |