| NPI | 1114353315 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CASEY FALEN Co Founder 631-317-8088 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MI 1-05-2325) |
| Enumeration Date | 2013-09-19 |
| Last Update Date | 2014-04-10 |