| NPI | 1073109112 |
|---|---|
| Former Legal Business Name | AVENUES OF OKLAHOMA |
| Entity Type | Organization |
| Authorized Contact | DANIEL MANDELBAUM CEO 718-570-6018 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2020-12-14 |
| Last Update Date | 2020-12-14 |