| NPI | 1104236603 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICTORIA DEXTER Vice President 347-328-8110 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NY 091151-1) |
| Enumeration Date | 2014-05-06 |
| Last Update Date | 2014-05-06 |