| NPI | 1104160514 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RHONDA NEVIN Office Mgr 516-822-4060 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NY R070907-1) |
| Enumeration Date | 2012-11-26 |
| Last Update Date | 2012-11-26 |