| NPI | 1093336125 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ESHIKA KALAM President 917-933-0584 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2020-04-29 |
| Last Update Date | 2020-04-29 |