| NPI | 1073234480 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBORAH JUDITH GORIN Clinic Administrative Manager 718-382-0045 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2022-09-06 |
| Last Update Date | 2022-09-06 |