| 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 |