| NPI | 1114301983 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DERRICK RICHARD CEO 929-526-8414 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251B00000X Case Management |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 101YP2500X Counselor, Professional | |
| 172V00000X Community Health Worker | |
| 251S00000X | |
| 251V00000X Voluntary or Charitable | |
| Enumeration Date | 2015-07-12 |
| Last Update Date | 2023-03-07 |