| NPI | 1063637817 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEE HUNTER PAVIS VP, CFO CIO 212-566-7713 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2800X Clinic/Center, Methadone Clinic (Licence: NY 00245689) |
| Additional Taxonomies | 251S00000X (Licence: NY 00245689) |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: NY 00245689) | |
| 324500000X Substance Abuse Rehabilitation Facility (Licence: NY 00245689) | |
| 261QP2300X Clinic/Center, Primary Care (Licence: NY 00245689) | |
| Enumeration Date | 2007-04-16 |
| Last Update Date | 2008-09-17 |