| NPI | 1114468220 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH JONES Clinical Cousnelor 718-542-8770 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2017-03-09 |
| Last Update Date | 2017-03-09 |