| NPI | 1093418378 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSHUA KOENIG CEO 718-954-5653 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
| Enumeration Date | 2023-03-24 |
| Last Update Date | 2023-03-31 |