| NPI | 1093258394 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACKIE CHESSEN Secretary Of State 516-965-1009 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NY 081431) |
| Enumeration Date | 2016-11-18 |
| Last Update Date | 2016-11-18 |