| NPI | 1073000733 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MILTON DERIENZO CFO 347-649-3083 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: NY 181212089) |
| Enumeration Date | 2018-04-18 |
| Last Update Date | 2018-07-02 |