| NPI | 1104603240 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LANA GRINEV Clinical Psychotherapist 347-666-7225 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2023-09-12 |
| Last Update Date | 2024-03-16 |