| NPI | 1124423520 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FERNANDO TAVERAS Owner/Physician 212-256-0725 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2014-10-28 |
| Last Update Date | 2014-10-28 |