| NPI | 1043099799 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACQUELINE DONGMO MEKONTCHOU Provider/Owner 347-898-0813 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2023-09-22 |
| Last Update Date | 2023-09-22 |