| NPI | 1124522818 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA GUEST Owner 718-451-6417 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: GA alpc009668) |
| Enumeration Date | 2018-03-19 |
| Last Update Date | 2018-06-16 |