| NPI | 1043764905 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRADLEY MARK RICHARDS President 516-721-7797 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NY 0005541) |
| Enumeration Date | 2016-08-09 |
| Last Update Date | 2016-08-09 |