| NPI | 1043584154 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ESTELLE A BROUSSEAU License Clinical Social Worker 718-356-0430 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: NY NYSR054862) |
| Enumeration Date | 2012-03-07 |
| Last Update Date | 2012-03-07 |