| NPI | 1124729066 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELI WRIGHT Owner/Provider 917-533-5332 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| Enumeration Date | 2023-03-16 |
| Last Update Date | 2023-03-16 |