NPI | 1093182255 |
---|---|
Entity Type | Organization |
Authorized Contact | WILLIAM FREDERICK GORDON CEO/Clinical Director 917-324-8439 |
Organization Subpart ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
324500000X Substance Abuse Rehabilitation Facility | |
Enumeration Date | 2015-08-24 |
Last Update Date | 2021-05-19 |