| NPI | 1093332595 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAWN D HART Owner 917-226-3834 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children |
| Enumeration Date | 2020-06-30 |
| Last Update Date | 2021-08-23 |