| NPI | 1093074825 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONOVAN ANTONIO LEIGH Counselor/Consultant 718-230-5100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder (Licence: NY 16697) |
| Enumeration Date | 2012-05-14 |
| Last Update Date | 2012-05-14 |