| NPI | 1063925998 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN SAULTERS Owner 347-218-1105 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP3300X Clinic/Center Pain |
| Additional Taxonomies | 251300000X Local Education Agency (LEA) |
| 251B00000X Case Management | |
| 251K00000X Public Health or Welfare | |
| 251S00000X Community/Behavioral Health | |
| 251V00000X Voluntary or Charitable | |
| 261QC1500X Clinic/Center Community Health | |
| 261QH0100X Clinic/Center Health Service | |
| 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) | |
| Enumeration Date | 2017-11-14 |
| Last Update Date | 2017-11-14 |