| NPI | 1053129593 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALBERT SHKLYAR Administrator 516-343-2772 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2024-12-30 |
| Last Update Date | 2024-12-30 |